Form online 2026

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The document outlines the California Consumer Assistance Program, which provides financial assistance to eligible vehicle owners for vehicle retirement or emissions-related repairs. Eligible individuals can receive up to $1,500 for vehicle retirement or up to $1,200 for repairs if their vehicle fails a Smog Check. The application process requires complete information and verification of income, with specific guidelines on eligibility and privacy practices.

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Click ‘Get Form’ to open the application in our editor.
Begin by selecting your program option. Choose either 'Vehicle Withdrawal' for $1,500 or 'Repair Assistance' based on your vehicle's eligibility.
Fill in the 'Vehicle Owner Information' section completely, including your first name, last name, address, and contact details. Ensure all fields are accurate to avoid processing delays.
If applicable, provide information for the co-owner of the vehicle in the designated section.
Complete the 'Vehicle Information' section by entering the year, make, model, VIN, and California license plate number of your vehicle.
In the 'Income Verification' section, indicate the number of people living in your household and provide your gross monthly and annual income.
Finally, sign and date where indicated to confirm that all information is true and correct before submitting your application.

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