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Click ‘Get Form’ to open the Smog Check Consumer Assistance Program Application in the editor.
In Section 1, select whether you are applying for Repair Assistance as an Income Eligible or Test-Only Eligible applicant, or if you are applying for Vehicle Retirement.
Complete Section 2 with your registered vehicle owner information, including your name, address, and contact details.
If applicable, fill out Section 2a for joint registered vehicle owner information.
Provide your vehicle information in Section 3, including the year, make, model, and VIN.
In Section 4, detail any emissions-related repairs you've paid for at a Smog Check station. Attach invoices if necessary.
Complete Section 5 by entering the number of people in your household and providing income information. Ensure all fields are filled accurately.
Finally, read and sign Section 6 to acknowledge the accuracy of your application before submitting it via mail.

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