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1:11~0/WOJO<IJt>la.Q"

A Pubflc Service Agency

AUTONOMOUS VEHICLE TESTER (AVT) PROGRAM
APPLICATION FOR MANUFACTURER'STESTING PERMIT
APPLICATION TYPE:

0
0

0
0

Original ~ 150
Renewal (Annual) S150
Modification $70
Additional Permits S50

CHECK THE APPROPRIATE BOX:

D

Address Change

D

GZI

Authorized Representative

Driver/Operator

[i) Vehicles

INSTRUCTIONS:
Please complete online or print and complete by hand using black or blue ink.
•
Submit completed and signed form and fees to: Department of Motor Vehicles, P.O. Box 932342
MS L224, Sacramento, CA 94232-3420

SECTION 1 -AUTONOMOUS VEHICLE TESTER INFORMATION

.•

.

E.f>N NUMBER

NAIJ.E OF MANUFACTURER

Apple Inc.
BUSIIIESS NAME

SECRETAAY OF STATE ENTll'll NUMBER

C0806592

Apple Inc.
8 US L~ ES S NAME LICENSED SY OV.V

AREA COOE!TEl.EPHONE NUMBER

( 408 ) 996-1010
CflY

STREET AD OR ESS

STATE

CA

Cupcnino

I [nfinite Loop

STATE

CITY

MAJUNG AOORESS OF DIFFERENT fROM STR££T ADDRESS)

CA

Cupenino

I Infinite Loop MS: 318-2CP

Company's training, testing, and employment records are kept at:

ZIP COO€

950!4

D

ZJ?COOE

950\4

Additional pages(s) attached.

FACIU!'{ NA.\OE

Apple Inc.
STATE

CITY

STREET ADO AESS

Cupenino

I Infinite Loop

CA

ZIP CODE

950]4

FACIU!'{ NMI E

STATE

CITY

STREET AOORESS

SECTION 2 -'v_EHICLES EQUIPPED FOR TESTING

ZIP CODE

List all vehicles in fleet.

Number of vehicles in flee1 .=.3_ _ _ __
PLATE NUMBER

STATE ISSUED

\/IN NUMBER

YEAR

MAK£

7MQV503

CA

2T2ZB IBA6FCOO 1564

2015

Lex us

R.X450h

0

PLATE NUMBER

STATE ISSUED

\liN NUMBER

YEAR

MAXE

MODEL

0AUTo

7VFG777
PLATE NUMBER

MODEL

0AUTo

CA

2T2ZB IBA6FC002926

2015

Lex us

RX450h

0

STATE ISSUED

VIN NUMBER

YEAR

MAXE

MODEL

0AUTo

7VUZ660

CA

2T2BCIBA2FC008381

2015

Lex us

RX450h

PLATE NUMBER

STATE ISSUED

VINNUMBEA

YEAR

MAXE

MODEL

0

SlATE ISSUED

OL311 (NE\'19/2013)\"/WW

YEAR

\/IN NUMBER

Page 1 of 4

MAI<E

MODEL

'COMMERCIAL

"COMMeRCIAL

OAUTo

0
PLATE NUMBER

"COMMERCIAL

'COMMERCIAL

OAUTo
0 'CO.~!MERCIAl

11111111111111111111111111111111111

 AVTNUMBEA

SECTION 2- VEHICLES EQUIPPED FOR TESTING
PLATE NUMBE.R

STATE ISSUED

conpnued
YEAR

VINNUMBER

MAKE

MODEL

DAUTo

0

'COMMERCIAL

?LATE N liMBER

STATE ISSUED

VINNLIMBER

YEAR

MA!<E

MODEl

PLATE NUM8.ER

STATE ISSUED

VINNUMBER

YEAR

MA!<E

MOOEL

PLATE NU~BER

STATE ISSUED

VIN NUMBER

YEAR

MA!<E

MODEt

OAUTo

PLATE NUMBER

STATE ISSVEO

VI,JNUMBEA

YS\A

MA!<E

MODEL

OAUTo

0AUTO

0 ·cow.tERCIAL
D J.JffO
D 'COMMERCIAL

D 'COMMERCIAL
D 'COMMERCIAl

• Refer to excluded vehicle list CCR 227.52

SECTION 3:- AUTONOMOUS VEHICLE DRlVERJOPERATOR

List all employees, cont~~~or~ and designees.

PANT TRUE FULL NAME (LAST. FIRST.I.liODLE)

ORIVEil LICENSE NUMBER

ISTATE ISSUED
CA

Gulati. Shilpa
TIUINING COI.IPLETION DATE

DATE ENROU.ED IN EMPUOYER PUll. NOTICE PROGAA\1

04/05/2017

03/2812017

PRINT TRUE FULL NAME (LAST. FIRST. AI/DOLE)

DRIVER LICENSE NUMBER

I

STATE ISSUED

CA

Heben, Paul
m..>J NIN G COMPLETION OATE

DATE ENAOU.EO IN O.IPLOYER PUll. NOTICE PROGRAM

04/05/2017

03/28/2017

PRINT TRUE FUU NmE !LAST. FIRST. MIDDLE)

DRIVER UCENSE NUMBER

I

STATE ISSUED

CA

Ma,Jeremy
l'N.AINING COMPLETION DATE

DATE ENROU.ED IN O.IF'LOYER PULL NOTICE PROGRA.\1

04/05/2017

03/2&/2017

PAl/'ll TRUE FULL N.WE I LAST. FIRST. MIDDI..E)

ORJVEA LICENSE NUMBER

I

STATE ISSUED

CA

Rosas, David
TRAINING COMPLETION DATE

DATE ENROU.ED IN E).IPLOYER PULL NOTICE PROGRAAI

04/05/2017

03/2&/20 17

PRINT TRUE fULL NAME (LAST. FIRST. MIDDL€)

DRIVER UCENSE NUMBER

Gadda, Christopher, David

~~ATE ISSUED

CA
DATE ENROU.EO IN EMPLOYER PULL NOTlCE PROGRAM

TRAIN INO COM Pl ET1 ON DATE

04/05/2017

03/28/1017

PRI.'TT TRUE FULL NAME (LAST. FIRST, MIDDLE)

ORI V EA UC ENS E N liMBER

Hwang, Victor, Chung

ISTATE ISSUED
CA

TRAINING C0'.1PLET10N DATE

DATE ENAOU.ED IN EMPLOYER PUll. t/OTICE PA0GRA'~

04/0512017

0312812017

PRINT TRUE FULL NA.'-IE (LASt FIRST. MIDDLE)

DRIVER LICENSE NUMBER

TRAINING COMPLETlQN DATE

DATE ENROUED IN E).IPLOYER PUll. NOTICE PROGRAM

PRINT TRUE fUlL NAME (LAST,FIFIST.MIDDLEI

ORI'IER liCE~SE NUMBER

TRAlNING COMPLETION DATE

DATE ENROLLED lrl EMPLOYER PUll. NOTICE PROGRAM

PRINT TRUE FUll. NMIE (LAST. FIRST. MIDDLE)

ORtvEA LICENSE NUMBER

TRAlNING 00MPL£llON DATE

DATE ENAOU.ED IN El'~PLOYE.R PUll. NOTICE PROGRAM

Page 2 of 4

l

STATE ISSUED

ISTATE

ISSUED

IsTATE ISSUED

OL311 (NEVI S/21l13J

vNI..,."

 l,:z.\'~,s~.6M.V,Lu_$g-Q~J-Ylt':!68!.:AvrNuMeER

NA\AE

SECTION 3 - AUTONOMOUS VEHICL~ DRIVER/OPERATOR continued
PRINT TRUE ~Ull NAME (LAS!; FIRSt MIDDLE)

DRIVER UCE.'ISE NUMBER

TFIAJNING CC\IPLETICN DATE

DATE ENROI.U::D IN EMPlO't'EA PULL NOTICE PROGRAM

PAINT TRUE FUll.. NAME (LAS r, FIFlST. MIDDLE)

OflNER UCENSE NUMBER

TFIAINING COMPI.CT10N DATE

DATE ENROLI.fD IN E.\! PLOVER PULL NO'TlCE PROGRAM

PRINT TRUE fUll NAME (LAST. FIRST, MIDDLE'J

DRIVER l.ICENSE NUMBER

TAAJNINO COMPLETION O..TE

D-\TE ENROLLED IN EM"LO't'ER PULL NOTICE PROGI\.\M

PAINT TRUE FULL NA.'/.E (LASi; FIP.Sr, MIDDLE)

DRIVER UCENSE NUMeER

TRAINING COMPlETION DATE

MTE ENRCUED IN EMPLOYER PULL NOTICE PP.OGRAM

PAINT TRUE FULL NAME (LASt fiRSt MIDDLE)

DRIVER UCENSE NUMBER

'ffiAINING COMPLETION DATE

DATE ENROLLED IN EMPLOYER PULL NOTICE PROGAA\1

PRINT TRUE FULL NAME (lAST. FIP.ST. MIDDLE)

DRIVER UCENSE NUMBER

TRAINING COMPLETION DATE

DATE E:'IP.OLL£0 IN EMPLOYER PULL NOTICE PROGRAM

PRINT TF.UE FULL NAIAE (LAST. FIRSr. MIDDLE)

DRIVER UCENSE •JU,.BER

1RAJN INO CCMP LETION DATE

O..TE ENROLLED IN EMPLOI'EFI PULL NOTICE PROGRA.\1

PAI:-IT TF\\JE FULL NAME (LAST. FIRST. MIDDLE)

OFIIVER UCENSE NUMBER

TRAINING COMPLETlON D,_TE

OATIE E.\!ROLLEO IN EMPLoYER PULL NOTICE PROGRAM

PAINT TRUE FULL NAME (LAS~ FIRST. MIDDLE:)

DI11VER UCENSE NUMSeR

TRAINING COMPlETION OAIE

OATE ENROLLED IN EMPLO't'ER PULL NOnCE PROQAA.\.1

PRINT TRUE FULL NAME (LASr. FIRST. MIDDLE)

DRIVER UCENSE NUM'BER

TRAIN! NO COMPLETION DATE

OATIE ENROLLED IN ~PLO't'ER PULL N011CE PAOGRJ..\l

PRI~IT TRUE

DRIVER UCENSE NUMBER

FULL NAME (LAST. FIRST./.IIDDLE)

TRAINING COI>I.PI..ETION DATE

DATE ENROLLED IN EMPLO't'EA PUl l NOTICE PROGRAM

PRINT TRUE FULL NAME (LAST, FIRST. MIDDLE)

DRIVcR UCENSE NUMBER

TRAJNII"iG C~-'PLETlON DATE

D-\TE ENROLLED IN EMPlO'I'ER PULL ~OTlCE PROGRAM

PRINT TRUE FUU. NAI.IE (LAS UIRS T. MIDDLE)

DRIVER UCENSE NUMBER

TR.o\JNING COMPLE'TlON DATE

DATE ENROLLED IN EMPLOYER PUll N011CE PROGI\.\M

0L 311 (NEW 9/2013)VIWW

Page 3 of 4

I STATE ISSUED

I STATE ISSUED

I STATE ISSUED

IST"'TE ISSUED

I STATE ISSUED

I STATE ISSUED

rTA!E ISSUEO

I

STATE ISSUED

I STAlE ISSUED

I STATIE ISSUED

I

STATE ISSUED

e

I STATE 1ssu D

I STATE ISSUED

 ~~D.Myj,O_S_E[O_N['(l.;.~~· ~
AVT NUMB ER

NAME

SECTION 4- APPLICANT ACKNOWLEDGEMENT
INITIALS
1.

The autonomous vehicle is being operated on roads in this stale solely by employees, contractors, or
other persons designated by the manufacturer of the autonomous technology.
2. The driver will be seated in the driver's seat, monitoring the safe operation of the autonomous vehicle
and is capable of taking over immediate manual control of the autonomous vehicle in the event of an
autonomous technology failure or other emergency.
3. An autonomous vehicle shall not be operated on public roads until the manufacturer submits an
application to the department and has been approved by the department.
4. The autonomous vehicle has a mechanism to engage and disengage the autonomous technology that
is easily accessible to the operator.
5. The autonomous vehicle has a visual indicator inside the cabin to indicate when the autonomous
technology is engaged.
6. The autonomous vehicle has a system to safely alert the operator if an autonomous technology failure
is detected while the autonomous technology is engaged, and when an alert is given, the system shall
require the operator to take control of the autonomous vehicle or if the operator does not or is unable
to take control of the autonomous vehicle, the autonomous vehicle shall be capable of coming to a
complete stop.
7. The autonomous vehicle shall allow the operator to take control in multiple manners, including, without
limitation, through the use of the brake, the accelerator pedal, or the steering whee\, and it shall alert the
operator that the autonomous technology has been disengaged.
8. The autonomous vehicle's autonomous technology meets Federal Motor Vehicle Safety Standards for
the vehicle's model year and all other applicable safety standards and performance requirements set
forth in state and federal law and the regulations promulgated pursuant to those laws.
9. The autonomous vehicle has a separate mechanism, in addition to, and separate from, any other
mechanism required by law to capture and store the autonomous technology sensor data for at least
30 seconds before a collision occurs between the autonomous vehicle and another vehicle, object, or
natural person while the vehicle is operating in autonomous mode. The autonomous technology sensor
data shall be captured and stored in a read-only format by the mechanism so that the data is retained
until extracted from the mechanism by an external device capable of downloading and storing the data.
The data shall be preserved for three years after the date of the collision.
iO. The driver will be seated in the driver's seat and has been identified in this application, and provided
training as outlined in the training materials submitted with this application .

S10/(_
Sm!L~Y?zL

Sfhk

11. The applicant for an autonomous vehicle testing program permit shall maintain records confirming all
driver/operator(s) driver license record is in compliance with the good driver criteria and shall immediately
remove such drivers from the testing program upon notification that the driver no longer qualifies for
participation in the program .
12. The operation of autonomous vehicles on public roads will be in compliance with all provisions of the
Vehicle Code and local regulations applicable to the operation of motor vehicles.
SECTION 5 "'"":'CERTIFICATION

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.

. dAd mm1s
.. tra toro f th e program for the above name employer.
I f urther ce rrt
1 y th atl am th eau th Of/Ze
PROGRAM

OI~ECTOF\IA\JTHORIZEO

Steven M. Kepnftr

REPRESENTATIVE PRJNTED NAME AND Trn.E

DRIVER UC ENS E NUMBER

....--?_

DAZ!i-7I -zo J 7

~QNATUq~/
STREE'T"?J)OR!;SS

I

'

IZIP CODE
950[4

Cf1'll

STATE

Cupertino

CA

EMAJL A.ODRESS

FAXNUM8ER

AA EA COD EfT ELEP HONE NUMBER

skenner@apple.com

(

808

I Infinite loop

Page 4of 4

)

)996-1010
CUll (NEW 9/'2013) 'iNN/

 April 12, 2017
Department of Motor Vehicles
Occupational Licensing Compliance Section
2415 1st Avenue. MS S441 (Courier Service Only)
Sacramento, CA 95818

Dear Director Shiomoro,
Apple is pro1Jiding the following written explanations in support of application form OL 311 Section 4, Applicant Acknowledgement, under the requirements of the Autonomous Vehicle
Tester Program.
Written explanation regarding section 4, #8 of form OL311, per OL312, Section 1.

As discussed with the Department of Motor Vehicles, section 4, ~8 of form Ol31l is not
applicable to development platforms used for testing pu rposes only.

Written explanation regarding section 4, #9 of form OL31l, per OL312, Section 1.
As discussed with the Department of Motor Vehicles, section 4, #9 of form OL311 is not
applicable to development platforms used for testing purposes only.
However. Applicant's development platforms will have the ability to capture and store
relevant data before a collision occurs.
If any clarification or further information is needed please contact me directly.

Sincerely yours,

x/!za;7/
\feve Kenner
Director of Product Integrity, Apple
Apple
11n~n i te

Loop, MS 301·3VG

Cupertino, (A 95014

T 408 996-10\0
F 40899~275
www.apple.com

 STATE OF CALIFORNIA

-:·, ... :;_DMV _USEONLY ;. :·._._ .,

DEPARTMENT OF MOTOR VEHICLES

A'/TNUMBER

AUTONOMOUS VEHICLE
MANUFACTURER SURETY BOND
(Vehicle Code Section 38750)

Licensing Operations Division
Occupational Licensing Branch
P.O . Box 932342, MS: L224
Sacramento, CA 94232-3420

09177739

Bond Number

Sl'l':ETY US£0;-:LY

59,450.00

Premium Amount

SURETYUSEOSL'r'

KNOW ALL PERSONS BY THESE PRESENTS:

That we, A

le Inc .
PRI:\CIPAL NA.\IE(SI AXIl DBA

doing business as an aUionomous vehicle manufacturer (section 38750 , Vehicle Code) whose address for service is

1 [nfinite Loop

Cupertino, CA 95014
Atrro~·o~ IOUS

VEHICLE ~IA..'NFACi\JRER ADDRESS

as PRINCIPAL . and

Fidelity and Deposit Company of Maryland

--------------------

SL'RETY t'A.\IE

a corporation organized under the laws of_M_a_ry_:_l_a_nd
_ _ _ _ _ _--:::-:-::=~==-:-:-:=-:-------------and authorized to transact a
STATE OF L"CORF'ORATIO.' I

general surety business in the State of California, whose address for service is

1299 Zurich Way, Schaumburg, IL 60196
SU ~

SER ~1CE ADDRESS

----------------------------·as SURETY, arc held and fumly bound to Lhc People of the State of

California in the p~nal sum of FIVE MILLION DOLLARS ($5 ,000,000). for which payment we bind our;c\vcs. our heirs, executors, administrators.
March 15, 2017
successors and assigns jointly and severally, firmly by these presents. The bond term shall begin on
80~'0

EFfECllVE DATE

WHEREAS, section 38750, Vehicle Code, requires lh~l the Principal file or have on file with the Dcpanmen1 a bond in the sum of $5 ,000.000
and this bond is executed and tendered in accordance therewith .
NOW THEREFORE, the conditions of the foregoing obligation arc that if the Principal satisfies any financ ial judgement for bodily injury. death ,
or property damage in a motor vehicle accident in an autonomous vehicle as delincd in California Vehicle Code section 38750 operated on California
public roads for testing purposes by or on behalf of the Principal, then this obUgation is to be void·. otherwise it is 10 remain in full force and effect.
PROVIDED HOWEVER, this bond is issued subject to the following express conditions:
(1) This bond shall remain in full force and effect for all liabilities incurred and for acts, omissions, or causes which arose before the
cancellation or withdraw!.
(2) This bond is executed by the Surety to comply with sections 38750 Vehicle Code, Chapter 2 (commencing with section 995 .010), ti tle
14, part 2 of the Code of Civil Procedure and Title 13. California Code of Regulations, Article 3.7, section 227.10, said bond shall be subject to
all the tenns and provisions thereof.
(3) The aggregate liability of the Surety hereunder on all claims whatsoever shall not exceed the penal sum of this bond in any event.
(4) This bond may be cancelled by the Surety in accordance with Anicle 13 (commencing with section 996 .310), chapter 2. 1i1le 14 , part 2
of I he Code of Civil Procedure.
(5) The Surety, ils successors and assigns. are jointly and severally liable on I he obligations of the bond, chapter 2 (commencing with
section 995.0 10), title 14, part 2 of the Code of Civil Procedure and Division 16.6, section 38750 of the Vehicle Code.
(6) The Principal and Surety may be served with notices, papers and other documents under chapter 2 (commenci ng with section
995 .0 I0). title 14. part 2 of the Code of Civil Procedure at the addresses given above.
I certify (or declare) rmder penalry of perjury. under rlre laws of tire State of California that r!Je foregoing is rrue twd correCt. The undersigned execlilt'S
this bond orr behalf of the surery rmder an unre1·oked power of arrorney.

Executed at

San Francisco, California

On (Date)

March 15,2017

P. Austin Neff
PRNTEDOR TYPED NA.\IEOF ATIOR.-.:EY-1:\-FACf

OL 317 (NEW 912013) V'IWW

lllllllllllllllllllllllllllllllllll

 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual
who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or
validity of that document.

STATE OF CALIFORNIA

)
)

COUNTY OF SAN FRANCISCO

)

On _ _. :.:k"""1a:.:. :rc.. : c:. :.:h;. :l:;. :5:;.:.•. =2:. .: 0. : . 1. :. 7___ before me, -----=D:....:·....:B::..:·-=D=ia:...z.._.N,::..:..::o~ta~'...c.Y...::P:..;t:.:..:lh:::..:l:.:..:ic=--Dau

(Hue insert11ame a11d Iitle af the officer)

personally appeared _ _ _ _ _ _ _....:Pc.:.·..:.A.::.:.t:.::I.S::.:I.:..::il.:....l:...N,:...:e:LJ{f'-------------NAME(S) OF SJGN£8(S)

w!to proved to me on the basis of satisfactory evidence to be tlte person(a) whose
names(s) is!a¥e subscribed to the within instrument and acknowledged to me that
84#!/he/l#ey e.x:ecuted tlte same in

lt#lhis/l#eH. signature{s)

Oil

lte#/Jis/~

authorized capacity(k!i), and tftat by

tlte instrument tlte person(5), or lite entity upon behalf of

which the person(s) acted, executed tlte instmment.

I certify under PENALTY OF PERJURY wzder the laws ojtlte State of California tltat

tllejoregoi11g paragraph is true and correct.

WITNESS my hand and official seal.

SigJJature af Notary

U

 ZURICH Ai'VlERICA.J.'IJ INSURANCE COMPM'Y
COLONIAL A..<\-IERICAN CASUALTY AND SURETY COMPANY
FIDELITY MID DEPOSIT COMPA.J.W OF MARYLA..t'-1>
POWER OF ATTORN'EY
Kl'\lOW ALL MEN BY THESE PRESENTS: That the ZURJCH A.J.\ifERICAJ'\l!NSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL Al'vfERICAN CASUALTY AJ\lD SURETY COMPANY, a corporation of the State of Maryland, and the FrDELITY
A.l\fD DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by
GERALD F. HALEY, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which
are set fonh on the reverse side hereof and are hereby cenilicd to be in full force and effect on the date hereof, do hereby nominate,
constirute, and appoint P. Austin NEFF, Emilie GEORGE and Jessica L. NOWLIN, all of San Francisco, California, EACH its true
and lawful agent and Attorney· in-Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all
bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presentS, shall be as binding upon said
Companies, as fully and amply, to all intents and purposes, as if they had been duly executed :md acknowledged by the regularly elected
officers of the ZURICH AMERJCAN INSlJR.AJ\JCE COMPANY at its office in New York, New York., the regularly elected officers of the
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected
officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper
persons.

The said Vice President docs hereby certify th:~t the extract set fonh on the reverse side hereof is a true copy of Aniclc V, Section 8, of
the By-Laws of said Comp3!1ies, and is now in force.
IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERiCAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, nnd
FIDELITY Al'li"D DEPOSIT COMPAJ\.'Y OF MA.RYLAA'D, this 6th day of April. A.D. 2016.
ATTEST:
ZURICH AMERICA.t'l INSURANCE COi\fPA.J'\1'
COLO!'iL\L AJ.\-t:ERICAN CASUALTV Ai''ffi SUR£11' COl'vrPANY
FIDELITY ,\1\1) DEPOSIT COMPA.t\'Y OF 1\-lARYLAl'tl)

By.

Secretary
Eric D. Barnes

Vice President
Gerald F. Haley

State of Maryland
County of Baltimore
On this 6th d:w of April, A.D. 2016, before the subs.:ribcr. a No tOll)' Public of the St~te of M~ryland, duly commissioned and qu.a.litied, GERALD F.
HALEY, Vice Prcs.idcnt, and ERIC D. BARNES, Secretary, of the Companirs, to me pcr.mna\ly known to be the individuals and officers dc:scnbcd in and
who executed U.e preceding instmmcnt, and acknowledged the execution of same, and being by me duly sworn, dc-poscth and saith, that he/she is the said
officer of U.e Company aforesaid, and thal the seals affi~ed to the preceding instrument arc the Corpornt~ Seals of said Compa.nirs, and th:H the said Corpor.uc
Seals and the signature as such officer were duly a(fu.ed and subscribed to the s:~id instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I h.avc hereunto set my hand and affixed my Official Seal the day :1nd yC3r first above wrincn .

Constance A. Dunn, 'No1:1ry l'ublic
My Commission Expires: July 9, 2019

POA-F 01&0580B

 . DMV USE ONLY

APPOINTMENT OF DIRECTOR AS AGENT
FOR SERVICE OF PROCESS

0LNUM6EA

I

I I

I

I

I

I

KNOW ALL MEN BY TI-IESE PRESENTS: That VWe $(even M. Kenner on behalf of Apple Inc .
PRINCIPAL:S TRUE FUll. W..\ll:(S) AND DEIA(S)

Autonomous Vehicle Tester
As Principal, who has applied for a license as a -----------------------~ hereby appoint(s) the Director of Motor Vehicles
TYPEUCENSE

as principal's tnJe and lawful agent upon whom all process may be served in any action, or actions which may hereafter be commenced against said
principal, arising out of any claim for damages suffered by any firm, person, association, organization, corporation or limited liability partnership, or
company, by reasor\ of che violatiorl by said principal of any of the terms and provisions ofchc California Veh.icle Code or any condition of the bond.
Principal further stipulates and agrees that, when personal service of process upon principal cannot be made in this State after due diligence, that
service can be made upon the Director of Motor Vehicles. In the event of the Director's absence from his/her office, that service can be made upon any
employee of the State of California in charge of the Director's office, and that such service of process shall be of the same legal force and effect as if
served upon the principal personally.

The principal further stipulates and agrees that the agency created by said appointment shall continue for and during the period covered by any license
that may be issued by the Departmc nt of Motor Vehicles, and so long thereafter as the principal may be made to answer in damages for a violation of
the California Vehicle Code, or any condition of principal's bond. The principal funher agrees !hat for purposes of venue, whenever service is made
upon the Director, the service shall be deemed to have been made upon principal in the cou7 in w7'ch principal has or last had his/her established
place Df business.
Lj ;

Zo / J

tN WITNESS WHEREOF, the said principal has hereunto set his hand the

)I

X

-

~c__

·NOT,;Rv.CEJqiFI¢AtE OF-ACKNQWLEDGE~~NT
c/

---

·~-.

-- _, .....

•'

SIGNA11JRc OF PAJNCIPAL

-·-

,·,

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this ccni.ficatc
is anached, and not the truthfulness, accuracy or validity of that document.
State of California
County of
On

50.

Apr:/

tl

f"'

(; /o. (

t?--

7,~ "Loll

beforeme,

f2(V1.V1 GrvfA

1\LIJf~,v PVlbf~·{,

!VI. /L

\fr:.

personally appeared
vr::n
(-YJ/)e/
who proved to me On the basis
of satisfactory evidence to be the pcrson(o') whose name~U\! subscribed to the within instrument, and acknowledged to me tha~s.hclthey
executed the same ir&Wherl~ authorized capaciry(~ and that b}@bd?ljldi' signature.(;r) on the instrument the person~, or the entity upon behalf
of which the pcrson(S") acted, executed the ins1rument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct
WITNESS my hand and official seal.
(SEAL)

·oR oMvJcHP oi=Ficf:R Aci<NbwLEDGEMENi"
oF siGNATuRE
-:.-:

I

On this day,
at this city, - - - - - - - - - - - - - - - - l \vitnesscd the signature of
the Principal, who based on satisfactory identification, executed under authorized capacity their signature before me.
I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true Md correct.
OE PART I.! Ei'll" OFF\CIAI. NAME & TITLE

·NOTE:
Officers and employees of the Department of Motor Vehicles {DMV) and the Department of lhe California Highway Patrol (CHP) are, far the purposes of
this code, authorized to administer oaths and acknowledge signatures. for which no fee shall be charged.
eve section 18
The instrument appointing the director as agenl for the applicant lor service of process shall be acknowledged by lhe applicant before a notary public.
eve sections 11102(a){S){e), eve 11202(a)(6)(C). 11403(d), 11710(d)
ADM 9050 (REV. 712015) WWW

 A07564 14
FILED.JeMJ
RESTATED ARTICLES OF INCORPORATION

Secretary of State
State of Catitomla

OF

JUN 0 6 2014

APPLE INC.

\Ch

Luca Maestri and D. Bruce Sewell certify that
1.

They are the Senior VIce President, Chief Financial Officer and the Senior VIce President,

General Counsel and Secretary, respectively, of Apple Inc., a California corporation.
2.

The Amended and Restated Articles of Incorporation of thi_s corporation are restated -to read

as setforlh In Exhibit A, attached hereto. Exhibit A Is hereby formally Incorporated herein by reference as if

fully set forth herein.
3.

The foregoing restatement of the Amended and Restated Articles of Incorporation has been

duly approved by the board of directors.
4.

This corporation has only one class of shares issued and outstanding, which Is Common

Stock, and no approval of the outstanding shares of this corporation Is required pursuant to Section 91 O(b)
of the California Corporations

Code.

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 A0756414
We iu rthe r dedar:e ·under p~ nai ty-~<:l:perju·ry:.under- th~ . l.aw.s.!0f.the ·state :o((a"ilforti'ta ·that ·the.-m.affer~
·set forth ~lh:thls;cet.tlfrca'te -are::true·.and <::Orred·of,out,·own:kn-oWied_g·e.

Executed at Cupertino, California on June -:/, 2014.

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Senlo'r;Vk~.-.

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EXHIBITA

RESTATED ARTICLES OF INCORPORATION
OF
APPLE INC.

A0756414
RESTATED ART(CLES OF INCORPORATION
OF
APPLE INC.

Tne n2me of the corporation is Apple Inc.
II

The purpose of this corporation Is to engage In any lawful act or activity for which a
corporation may be organized under the General Corporation Law of California other than the
banking business, the trust company business or the practice of a profession permitted to be
Incorporated by the California Corporations Code.

nr
This corporation Is authorized to issue one class of shares designated ucommon Stock,"
p.:r value $0.00001 per share. The number of shares of Common Srock that this corporation Is
authorized to issue Is 12,600,000,000. As of 5:00 p.m., Pacific Daylight Time, on June 6, 2014, each
share of Common Stock outstanding shall. be automat!cally, and with no further action by the
hold~r of such sh2re, spilt Into seven shares of Common Stock.
IV
Section 1. Limitation of Directors' Uability. The liability of the directors of this corporation
for monetary damages shall be eliminated to the fullest extent permissible under California law.
Section 2. Indemnification of Corporate Agents. The corporation is authorized to provide
of agents (a5 defined in Section 317 of th~ California Corporations Code)
through bylaw provisions, agreements with agents, vote of shareholders or dIs Interested
directors or otherwise, In excess of the lndemnlficctlon otherwise permitted by Section 317 of
the California Corporations Code, subject only to the applicable !lmlts set forth In Section 204 of
the California Corporations Code with respect to actions for breach of duty to the corporation
and Its shareholders.
lndemnific~tion

Section 3. Repeal or Modification. Any repeal or modification of the foregoing provisions
of this Article IV by ~he shareholders of this corporation shall not adversely affect any right or
protection of an agent of this corporation existing at the time of such repeal or modification.

v
.

~9tes

There shall be no right with respect to shares of stock of this corporation to cumulate
in the election of directors .

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9333 ?Ems $8322,

 

Apple Inc.- Officers and Directors

Timothy D. Cook

Director

1 Infinite Loop,
Cupertino, CA 95014

Albert Gore, Jr.

Director

1 Infinite Loop,
Cupertino, CA 95014

Robert lger

Director

1 Infinite Loop,
Cupertino, CA 95014

Andrea Jung

Director

1 Infinite Loop,
Cupertino, CA 95014

Arthur 0 . Levinson

Chairman

1 Infinite Loop,
Cupertino, CA 95014

Ronald D. Sugar

Director

1 Infinite Loop,
Cupertino, CA 95014

Susan Wagner

Director

1 Infinite Loop,
Cupertino, CA 95014

Timothy 0 . Cook

Chief Executive Officer

1 Infinite Loop,
Cupertino, CA 95014

Luca Maestri

Senior Vice President, Chief Fin andal Officer

1 Infinite Loop,
Cupertino, CA

o. Bruce Sewell

Senior Vice President, General Counsel and Secretary

1 Infinite Loop,
Cupertino, CA

Gary J. Wipfler

Vice President and Corporate Treasurer

95014
1 Infinite Loop,
Cupertino, CA 95014

Michael Shapiro

Assistant Treasurer

1 Infinite Loop,
Cupertino, CA 95014

KyleAndeer

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

James Fowler

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Noreen Krall

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Thomas R. La Perle

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Gene D. Lev off

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Tom Moyer

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Douglas G. Vetter

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

Bruce H. Watrous Jr.

Assistant Secretary

1 Infinite Loop,
Cupertino, CA 95014

95014

 Apple Automated System: Traini?g Plan

Apple Automated System: Development Platform Specific Training Overv1ew
Objective: To train safety drivers in various automated driving conditions
Training procedure:
Development platform will be controlled electronically (e.g. joystick} and safety drivers must be ready to intervene and take control
Each safety driver will be given 2 practice runs and 3 trials to pass each test

Type

Item
Low Speed Oriv1ng

Training Areas

Goal

Sal ely driver srlOuld take control in case of
• steermg otf the course (lane)

:Maintain speed and stay Vlllhin the course(lane) at 30m ph
-- --···

Basic Maneuver

' •• '

·····-·

- speedov~andunder30mph

.....

~·-···· ·

.. ··-'"" ... ............

.•..

....

-------- - -- - - --- - -·- -·------·

'Maintil'n speed and stay \'llthin the course(lane) at 65mph

Sal ely Clr.ver sh oul d lake control in case of
, • sleer.ng oil the course (lane)
. • speed over and under 65mph

:Stay within the course during the I0\'1 speed tight turn control under Intervention

· Sale!y dr~ver should take control in case or
; ·steering off the course (lane)

Sudden Steertng Input

~ Ma nual override by grabb1ng Ihe steer.ng

:Sal cry driver should lake control

Sudden Acceleratton

~ M11nuat overr ide by pressing the brake pedal

. Sat cry driver should lake control

Sudden Braktng

~ Manual overrrde by pressing the brake pedal

: Safery

~ M<tnual overndelly grabbing lhe steering wheel and make the lane change

: Salery driver should take conlrol in case or
: ·lane change request no11n a designated area

Htgn Speed Driving

j... ... ... .. .... ' . ··--

T1ght U-Turn

- - --- ·-- .. ..~ . ......,. . ............

Intervention

Situational

Confhcling Turn Signal and Acticn

dr~ver

should lake control

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 Apple Automated System: Lovv Speed Driving

Training Goal

Conditions

Safety driver should ensure development
platform stays within the course while
maintaining 30mph

Track length : 0.25 Miles
Track width : 15 feet
Road shape : Straight
Development PlaHorm State : Trainer driving
using OBW controller

Manual 1nput behaviors
Safety driver should be able to accelerate w/o overriding the

08\N mode
Press1ng the brake pedal or grabb1ng steering wheel will dis·
engage OBW mode and safety driver should take manual
control of the development platform to complete the course

.,.....__ Automatic driving
.... . .

Manual override path expected

carr41 r~ff =l1

 Apple Automated System: High Speed D1·iving

Safety driver should ensure tile development

Training Goal

Conditions

platform stays within the course wl11le
maintaining 65mph

Track length .. 36 miles
Track width : 15 teet
Road shape : Straight
Development Platform State : Tra1ner driving
using OBW controller

Manual input behaviors
Safety driver should be able to accelerate w/o overriding the

DBW mode
Pressing the brake pedal or grabbing steering wheel will disengage OBW mode and safety driver should take manual
control of the development platlorm to complete the course

Automatic driving
-o11111 ·

·

Manual override path expected
0:\}r:"t;f m": l

 Apple Automated System: Tig l t U-Tu rn

Training Goal

Development platform will enter tight U-turn
zone
Safety driver should ensure the vehicle stays
within the course wh1le maintaining 15 mph

Conditions

Track length : xx miles
Track width : 15 meters/feeuyards
Turning Radius: 42 Ft Turning Radius to outer
ring
Road shape: Tight curve (U-Turn)
Development Platform State : Trainer driving
using DBW controller

Manual input behaviors
Safety dnver should be able to accelerate w/o overriding the
DBWmode
Pressing the brake pedal or grabb1ng steering wheel will disengage DBW mode and safety driver should take m<muat
control of the development platform to complete the course

Automatic driving
Manual override palh expected
f: ,J- [\T (}o:-:1' ~-L f

 Apple

Automated System: Suclden Steering Input

Vehicle will make a sudden man ewer to the
right or lett turn on a wide straight lane

Training Goal

· Safety driver should inteNene by grabbing lhe
steering v-.1heel and correct the path to stay
within the lane
Track length : 0.25 miles
Track width : 20 meters/feeUyards

Conditions

Road shape : Straight
Development Platform State : Trainer driv1ng
using DBW controller

Manual input behaviors
Safety driver should be able to accelerate w/o overriding the
OBWmode
Pressing the brake pedal or grabbing steering wheel will dis·
engage DBW mode and safety driver should take manual
control or the vehicle to complete the course
....,_, Automatic driving
<IIIII · ·

Manual override path expected
Con·.•:K'~'Y~

 Apple Automated System: Sudden Acceleration

Training Goal

Vehicle will accelerate fast suddenly on a wide
straight lane
Safety driver should intervene by pressing the

brake pedal and maintain the speed limit
Track length : 0.25 miles
Track width : 15 Feet
Conditions

Road shape : Straight
Development Platform State : Trainer driving
using DBW controller

Manual input behaviors
Safety driver should be able to accelerate w/o overriding the
DBWmode
Pressing the brake pedal or grabbing steering wheel will disengage OBW mode and safe!'/ driver should take manual
control of the vehicle to complete the course
~· Automatic driving

Manual override path expected

~..=·<::.r:d':f"• ;'\J

 Apple Automated System: Suclden Braking

Training Goal

Vehicle w ill make a sharp brake suddenly on a
wide straight lane
Safety driver should intervene by presstng the
brake pedal and maintain the speed limit

Conditions

Track length : 0.25 miles
Track width : 15 feet
Road shape : Straight
Development Platform State : Trainer driving
using DBW controller

Manual input behaviors
Safety driver should be able to accelerate w/o overriding the
DBWmode
Pressing the brake pedal or grabbing steering wheel will disengage DBW mode and safety driver should take manual
control or the vel1icle to complete the course

...,.._. Automatic driving
Manual override path expected
r:.lr .' . r~~.! ::J

 Apple Automated System: Lane Change

Vehicle turns on rigl1t lurn signal to indicate

Training Goal

nght lane change at the dtvided section but
drives straight
Safety driver should inteiVene and change to
the right lane

Conditions

Track length : 025 mtle
Track width : 15 feet
Road shape : Slraight
Development Platform State : Trarner dnving
using DBW controller

Manual input behaviors
Safety driver should be able to accelerate wJo overriding the
OBWmode

Pressing the brake pedal or grabbing steering wheel will disengage DBW mode Md safety driver should take m<~nual
control or the vehicle to complete the course

-4---

Automatic driving

,. • •

Manual override path expected

C. Uft'lrf•T'll -. tl

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, ;-;~£

IS _~ig~~~tJ~R~GISTRATION

CARD OR A FACSIMILE COPY IS TO BE KEPT WITH THE
IC"fjE:· FOR"WHICH IT IS ISSUED. THIS REQUIREMENT DOES NOT APPLY WHEN THE
ICLE·,)fs';,LEFT·',:iJNATTENDED. IT NEED NOT BE DISPLAYED. PRESENT IT TO ANY PEACE
OFFICER UPON DEMAND . IF YOU DO NOT RECEIVE A RENEWAL NOTICE, USE THIS FORM
TO PAY YOUR RENEWAL FEES OR NOTIFY THE DEPARTMENT OF MOTOR VEHICLES OF THE
PLANNED NON-OPERATIONAL STATUS (PNO) OF A STORED VEHICLE. RENEWAL FEES MUST
BE PAID ON OR BEFORE THE REGISTRATION EXPIRATION DATE OR PENALTIES WILL BE
DUE PURSUANT TO CALIFORNIA VEHICLE CODE SECTIONS 9552 - 9554.

EVIDENCE OF LIABILITY INSURANCE FROM YOUR INSURANCE COMPANY MUST BE PROVIDED
TO THE DEPARTMENT WITH THE PAYMENT OF. :RENEWAL FEES. EVIDENCE OF LIABILITY
INSURANCE IS NOT REQUIRED WITH REG:f'sTRAT.i:ON~·.-RENEWAL OF OFF-HIGHWAY VEHICLES
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 STATEMENT OF FACTS
Complete the appropriate section(s) in full (Including vehicle description) and sign Section H.
UCENSE PlATEiCf NUMBER

VE!iiCLf/VESSEI. I0 N U~l SI:R

YE.ARIUAJ<E

7HQV503

2T2ZB1BA6FC001564

2015 I Lexus
•

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This transfer Is exempt from use tax because It Is a:
Family transfer sold between a parent, child, grandparent, grandchild, spouse, domestic partner, or siblings (if both are
minors related by blood or adoption).

0

0
D
D

Addition or deletion of family member (spouse, domestic partner, parent(s]. son/daughter, grandparents, grandchildren).

Gift (does not include vehicles traded between individuals, transfer of contracts or other valuable consideration).
Court Order
D Inheritance
NOTE: The Use Tax Exemption cannot be claimed If the vehicle/vessel being transferred was purchased from an
otherwise qualifying relative who Is engaged in the business of selling the same type of vehlclelvesseL

The current market value is: S_ _ _ _ _ __

The vehicle does not require a smog certification for transfer of ownership because:
The last smog certification was obtained within the last 90 days.
D It is powered by:
0 electricity
0 diesel
0 Other-----------0 11 is located outside the State of California. (Exception: Nevada and Mexico)
0 II is being transferred from/between:
0 The parent, grandparent. child, grandchild, brother, sister, spouse, or domestic partner (as defined in
Family Code §297) of the transferee. •
0 A sole proprietorship to the proprietor as owner:
0 Companies whose principal business is leasing vehicles . There is no change in lessee or operator. •
0 Lessor and lessee of vehicle, and no change in the lessee or operator of the vehicle.•
0 Lessor and person who has been lessee's operator of the vehicle for at least one year. •
0 lndividual(s) being added as registered owner(s). •
• Does not require smog certification unless Biennial Smog is required.

0

.

·-·

·,.'•

This vehicle has not been used or parked on a street or highway or off-highway. I am applying for a:
Transfer Only
0 Title Only

0

The vehicle is not currently registered. It has not been driven, moved, towed. or lett standing on any California public
highway to cause registration tees to become due. It was not transported over any California public highway or operated
within California to cause oH-highway fees to become due. Appropriate registration will be obtained before the vehicle is
operated.
.
.

·- .. .

Enter your Disabled Person License Pia te, or Disabled Veteran License Plate, or Permanent Disabled Person Parking Placard
number below:
CISASI.EO PERSON J>l.AI E

C<SA81.1:D VETEAAtl PLATE

PERMANENT OISADLED P£1\SON PV.CAAD

The vehicle to which m Window Decal will be affixed is:
UCEN SE NUMBER

Vf>!ICLE 10 NUUBE"A

Mail to:
NAME

ADOIIESS

ClrY

REC 2~ (11£\1. &"2008) WWW

ST...TE

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 STATEMENT OF FACTS
Complete the appropriate section(s) in full (including vehicle description) and sign Section H.
YEAI'IIMME

UC£NSE PI..AtEJC; NUMBeR

7MQV503

2015 I Lexus

The current market value of the vehicle or vessel is:
Changes were made at a cost of$

$_ _ _ _ _ __
on this date - - - - - - -

This is what I changed: Check all that apply:
Unladen Weight changed because
Motive Power changed from
Body Type changed from
0 Number of Axles changed from

0
0
0

(Public Weighmaster Certificate is required. Exception: Trailers)
to - - - - - - - to------to,_ _ _ _ _ __

Please print

0

I , - - - - - - - - - - - - - - - a n d - - - - - - - - - - - - - - are one and the same person.

0

My name is misspelled. Please correct it to: - - - - - - - - - - - - - - - - - - - - - - - - - - -

0

I am changing my name from

I, the undersigned, state:

Applicant certifies that the development platforms that it is registering under the CA
DMV Autonomous Vehicle Tester Program will be used solely for the purpose of testing .
During all on-road testing, a trained and alert safety driver will monitor and supplement
the use and controls of the development platform being tested. The development platform
uses hardware and software to monitor surrounding objects and events. The development
platform is capable of sending electronic commands for steering, accelerating, and
decelerating and may carry out portions of the dynamic driving task.

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing Is true and
correct.
PFIINTEO LAST NAME

Kenner
SIGNATURE

X

FIRST W..\IE

MIOOU: N;U.<E

DA'fllME PHONE NUMBER

Steven

M.

( 406 ) 996-1010

 Smog Check Vehicle Inspection Report (VIR)
V~hid,, lnform~tion

T.:~t D~tdT imc:

il.!udc1 YCJL

03(.\ 1/~0 17 @, 2:.\7 l't-1

L.•~cnst:"

Plate:

Vehicle Mndd:

Vehicle Make:
LEX US
~T2ZU I OMFCOO 15{14

20l.S

VIN (sc~nncJ from l"~hic1c):

7.\IQVSO.\

Ccrtific3tion Type: California

IL\: 450ft
~nginc

License St.lle:

Cr\

Fuel Type:

Hybnd

O<.lomctcr:

l)li'J-1

GVWR:

6.000 and kss

(p>/clcctric)

0Hrall Test llcsuiJ
PASS

ConJ;r;nu!Jiions! Your \"chide p:!.~Scd Ihe SIIIO_I! Check in~pcctinn. which helps c~lifumb reach it~ daily goal of removing
c-mi~<i(ln., fn>nl the air. Th:tuk yon ti>r h-cping your ,·chicle well maiutainc<.l.
Visual Inspection: PASS 1-'unctionallnsp.:ction: I':\5S

~nlll~-fumlillg

Smog Oteck Certificate Numh~r: ZN9.~5.1.lSC
DMV m Numb<.·~ bl~'lN7qZ~6-!
Y our Smog Check ccn i f"k~tc ha.< been dcctronicall)' trJn<tnt!icd It>
Your certificate is valid (or '10 tbys from Jah: of i>.<tuncc.
l'lc-:~sc

keep this cupy for

~uur

1)~1 V.

rc•(c)rJs.

Visual Ill\ peel inn
Re~ult

ln,;p('c'tiou

NOTAPI'LICJ\BLE

Air Injection Syst~m

C~tq:ory

I' ASS

t()mpurcrs.

1'1\SS

Exh.w~t Ga~

S,·nsor~. Swirchc·~. ~net

Wiring

l<e,ircubtion ( EC.R)

l~e.,u It

Cate~or\"

Rc..mlr

lusp<ecrion

PASS

C3t..ll~·~t

I' ASS
1',\SS

Cr.mk~:..sc lc:mi~,ion

Other Enti,siun Relate-d Cnmponcnt.~-'Sy.<tcnl<
Vacuum Liuc> 10 Set"t•r>JSwirdtc.<

PASS

Fu.:l Metering- Sy~tcm

PASS

:\OTAPI'LICAnU:

T•ul•l1-:l•~r~c·r1Sup,·r.:h:ugcr

I' ASS

Rc,;ull

In (orn1 :II t(ln

Couuols

fud E''3por3ti'"c Sy~rcm (1:\'AP)

ltcsulr

Liquid l'ud

!'ASS

Lc~~

CltL"Ck

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OUDII

Smoc Cheek lm11ation Sr~tlon I nrorm~tinn
N~mcJID:

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ln,pcctor

DON

f.:.

Sof\w~r~ Vc~>i(>tt/OIS

I o.~o

(; El. (" A:-.11 NO IH~r\1.

JOHNS AUT(),\IOTIVE

SUNNYVALE, CA 'lJOl\6
(-10~)

73'J-III'J

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donjnhn~~ulooc1. ~ rnJil.c'c•• n

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IS .Y.Mi'·;I;_P.,_r~r)'-'"REGISTRATION CARD OR A FACSIMILE COPY IS TO BE KEPT ~HTH THE
ICLE .. FOR' 'NHICH IT IS ISSUED. THIS REQUIREMENT DOES NOT APPLY WHEN THE
ICL'£ .-·'!r-s" 'LEF·T;:·lJN'ATTENDED. IT NEED NOT BE DISPLAYED. PRESENT IT TO ANY PEACE
OFFICER UPON DEMAND. IF YOU DO NOT RECEIVE A RENEWAL NOTICE, USE THIS FORM
TO PAY YOUR RENEWAL FEES OR NOTIFY THE DEPARTMENT OF MOTOR VEHICLES OF THE
PLANNED NON-OPERATIONAL STATUS (PNO} OF A STORED VEHICLE. RE~ffiWAL FEES MUST
BE PAID ON OR BEFORE THE REGISTRATION EXPIRATION DATE OR PENALTIES t'IILL BE
DUE PURSUANT TO CALIFORNIA VEHICLE CODE SECTIONS 9552 - 9554.

EVIDENCE OF LIABILITY INSURANCE FROM YOUR INSURANCE COMPANY MUST BE PROVIDED
TO THE DEPARTMENT WITH THE PAYMENT _QF.::JU:NEWAL FEES. EVIDENCE OF LIABILITY
INSURANCE IS NOT REQUIRED IHTH R.¥. <JI·§!:*·~ION.?R.~t.JEWAL OF OFF-HIGHNAY VEHICLES,
TRAILERS, VESSELS, OR IF YOU F ;...r:{~·-PNO' ?N ~1~~2{EHICLE.
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WHEN 'iiRITING TO DlvfV, ALWAYS G+VJ?:·'Y'q,tJ~·~ F~Li:-:.N~tE'.)"\l,PRESENT ADDRESS, AND THE

VEHICLE MAKE, LICENSE, AND

IDENT·IF.I-CAT~ION (, N1Jl.lBERS 1 •

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REGISTRATION CARD VALID FROM: 10/08/2016 TO: 10/08/2017
VLf" c~ss

LEXS

0000

2015

EOOY TYPJ! llOOEL

UT
TVP:S VDI:ct.B IJSE

AUTOMOBILE

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2016

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2T2ZB1BA8FC002926
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03/31/17

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03/31/17

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2550
PR EXP DATE: 10/08/2017
AXOutr; P.r. I D

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APPLE INC
3000 LAKESIDE DR STE 2

BANNOCKBURN

IL

7VFG777

\'EHICt,.t 10 !M1116lt

MO

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L I C~tl~£ )MI[)f.R

60015

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MISC#:

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$ 2593.00

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STATEMENT OF FACTS
Complete the appropriate section(s) in full (including vehicle description) and sign Section H.
V1: HICI.EN ESS EL 10 NUM6E R

LIC€>1.SE PlATEICF NU..,BER

7VFG777

A;

I Lexus

2T2ZB1BA6FC002926

STATEMENT, FOR.USETAx EXEMPTION " -~ -.•.
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This transfer Is exempt from use tax because il is a:

0

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Family transfer sold between a parent, child, grandparent, grandchild, spouse, domestic partner, or siblings (if both are
minors related by blood or adoption) .
Addition or deletion of family member (spouse, domestic partner, parent[s]. son/daughter, grandparents. grandchildren).
Gift (does not include vehicles traded between individuals, transfer of contracts or other valuable consideration).
Court Order

0

Inheritance

NOTE: The Use Tax Exemption cannot be claimed if the vehiclelvessel being transferred was purchased from an
otherwise qualifying relative who is engaged in the business of selling the same type of vehicle/vessel.
The current market value is: S_ _ _ _ _ __

The vehicle does not require a smog certification for transfer of ownership because:
The last smog certification was obtained within the last 90 days.
0 It is powered by: D electricity
0 diesel 0 O t h e r - - - - - - - - - - - 0 It is located outside the State of California. (Exception: Nevada and Mexico)
0 lt is being transferred from/between:
0 The parent, grandparent, child, grandchild, brother, sister, spouse, or domestic partner (as defined in
Family Code §297) of the transferee:
0 A sole proprietorship to the proprietor as owner. •
0 Companies whose principal business is leasing vehicles. There is no change in lessee or operator. •
0 Lessor and lessee of vehicle, and no change in the lessee or operator of the vehicle. •
0 Lessor and person who has been lessee's operator o1the vehicle for at least one year.·
0 lndividual(s) being added as registered owner(s)."
• Does not require smog certification unless Biennial Smog is required.

0

r,.,

II

This vehicle has not been used or parked on a street or highway or off-highway. I am applying for a:
Transfer Only
0 Title Only

0

The vehicle is not currently registered. II has not been driven, moved, towed, or left standing on any California public
highway to cause registration fees to become due. It was not transported over any California public highway or operated
within California to cause off-highway fees to become due. Appropriate registration will be obtained before the vehicle is
operated .

Enter your Disabled Person Ucense Plate, or Disabled Veteran License Plate, or Permanent Disabled Person Parking Placard
number below:
PERMAN H IT DISABlED PERSOI.I PLACARO

DISABLED PERSON PLATE

The vehicle to which m Window Decal will be affixed is:
UCENSE NUM8ER

VEHICUE MAKE

Mail to:

ADDRESS

crrv

STATE

liP

 STATEMENT OF FACTS
Complete the appropriate sectlon(s) In full (Including vehicle description) and sign Section H.
liCENSE PLATEICF Mi!.I&R

7VFG777

Vl:I<ICLENESSEL ID r<UMIIEA

Y~W<E

2T2ZB1BA6FC002926

2015 / Lexus

The current market value of the vehicle or vessel is:
Changes were made at a cost of S

S_ _ _ _ _ __
on this d a t e - - - - - - - -

This Is what I changed: Check all that apply:
Unladen Weight changed because
0 Motive Power changed from
0 Body Type changed from
0 Number of Axles changed from

0

(Public Weighmaster Certificate is required. Exception: Trailers)
to - - - - - - -

to------to _ _ _ _ _ __

-,.' : . .
Please print

0

J, - - - - - - - - - - - - - - - a n d - - - - - - - - - - - - - - - are one and the same person.

0

My name is misspelled. Please correct it t o : - - - - - - - - - - - - - - - - - - - - - - - - - - -

0

I am changing my name from

I, the undersigned, state:

Applicant certifies that the development platforms that it is registering under the CA
DHV Autonomous vehicle Tester Program will be used solely for the purpose of testing.
During all on-road testing, a trained and alert safety driver will monitor and supplement
the use and controls of the development platform being tested. The development platform
uses hardware and software to monitor surrounding objects and events. The development
platform is capable of sending electronic commands for steering, accelerating, and
decelerating and may carry out portions of the dynamic driving task.

.

.~ ~ •'.,.

..

.·

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ol.

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I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and

correct.
l>fii"T<O LAST NAME

Kenner

FlAST NAME

MHXlLE NAME

IMYTIME PHONE NUM~fl

Steven

M.

( 408 ) 996-1010
DATE

X
REG 2S61~. &~) \WIVI

 Smog Check Vehicle Inspection Report (VIR)
Jnr~>rrn~1ion

Vehicle

f .:~t Daldrim<!: 0313 I i~O I 7 r:l; I:21 Pl\.1
Vchicl<: ~l:~kc:

2015

1'-\o!.lcl \'c'lr;

Liccru.:

PI:~!.::

Vehicle i\\odd :

LEXUS

IL'\ 4501-1

~~ZO I nASFC002'J2fl

Vl."l (scann.:J fron1 ''chide):

7VFG777

LiccnS( Stale:
Odomclcr.

Ccrtificalion Type: C<llifornia

CA
9571

Fuel Typ.: :

Hybrid cngiuc (g~sicln·•ric)

GVWR:

b.OOO and k~-~

0\'crall 1"(31 Result
PASS
Con~tublions! Your whiclc
Cflli<;.~ions

p:..sscJ Jhc Smo~ Chcdi: inspection. \\ hich help( C:~lifumi:t rc~ch i1s U:oily goal of rcmovint: ,-mog-fomlin!;
(mm !he air. llia111.: )IOU f<>r kccpint; your vchidc u.•cJI Ol:lint:lincJ.
Vi~u.-.1 lnspcctiom: PASS Funclionallns pcclion: I' ASS

Sm<>g Chcd CcnilicJic Nuonho:t: ZN91\5J.HC:
DMV ID Number. 2SJ7N792Z2M
Your Smog Chcd ccrtilic~Jc h:1.< been clcctronical\y tran.,miucJ lo Dt>.IV.
Your ccrtiftcalc i> I' a lid for 90 tbys from dale of issu:~ncc,
Please keep lhi ..; copy for your r~cMtk
\'i~u:1llnsm· e~ion

({null lnrorm~linn
Rc•ull

ln.;p~clion Cuc~m'V

PASS

C:•talysl

PASS

Crankc' ~$c Emis~iotl

PASS

lnijl<'Ciion Cal~gur.·
Air lujc((ion Sy~tc111
Compulcr<, Scnwn:. Switch.:~. ~ntl Wiring
J:: _,h~u-'t (i~s lkcir~ulation (ECiR)

P,\SS

Fuel

P,\SS

fud lvlcl,·rill!: Sys1cn1

PASS

Other

NOTt\ I'I'UCA OLE

Tur\)(l..-ll:trg~ri Supcrch~rgcr

PASS

V~.:uum Liuc.< In Scn>or:>!Swil.:hcs

Result

NOTAPPLICAULE
PASS

F.miHinn Con1rn\

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R<:suh

(f:VAP)

Etui~s inn Rd~I.:J Cumpnncui~Sy~l.:m~

FuPclinnol Cheri; lt~wlts

l{c.;ulr

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r,,ss

Li<.juiJ Fuc'l lcJk Check

SmM Check ln.< pcctinn
S1~11on

Conunls

f:,·Jpor:~li\'c Sy~ lcm

ID:

00011

Sl~lion lnrnrm~lion

lo~pc.-tur ~;omc1lD :

RC20J925

DON & JOHNS AUTOMOTIVE
10.~0 E El CA~IINO RI.:.J\1.
SUN1\:\'V ,\LE. CA 9-IO!"t.

Suflwarc

Vcr~iuw'OIS

GORDON. ANTHONY/ F0070061\
ID:

lo. 7.9'13.0/C\'0(\-l7,1(,

(40S) 7J 11-I I I<J
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I ccrtil)·. under penally of perjury. unJcr Ihe \;~w.< nrthc Slak ofCJiofomi:.. 1hat I pcrl'omicJ the in.<f'lcCiion in ~rcortJ.,ncc with Jtll:>urc~u
1cquirrmcnt~.

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Ihi> V('hidr insprrlion rcpnrll.' Jmc and a(t:Uralc.

 ~~D~ OR A rACSIMILE COPY IS TO BE KEPT WITH THE
~
THIS REQUIREMENT DOES NOT APPLY v1HEN THE

NEED NOT BE DISPLAYED . PRES~T IT TO ANY P~CE
NOT RECEIVE A RENEWAL NOTICE, USE THIS FORM
~~~~IFY THE DEPARTMENT OF MOTOR VEHICLES OP THE
; (PNO) OF A STORED VEHICLE. RENEt<Ji\L FEES MUST
ISTRAT!ON EXPIRATION DATE OR PENALTIES vliLL BE
VEHICLE CODE SECTIONS 9552 - 9554.

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INSURAi¢~

£\J!DENCE OF LIABILITY

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COMPANY MUST BE PROVIDED
TO THE DEPARTMENT WITH THE ~NT. . OF';~Ar-.; ·~EES. EVIDENCE OF LIABILITY
INSURANCE IS NOT REQUIRED W ~-_;.~(7,i~'f~~ .'R~AL OF OFF-HIGHWAY VEHICLES 1
TRAILERS VESSELS OR. IP YO ,;E~I&~:A - :~.·_
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· ·.:;f:EHIC!.E.
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PRESENT ADDRC:SS ,

AND T HE

ID~_f:~l~.~op_to~·(mwraERS.
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DO NOT DETACH - REGI STEREO 0\'MER INFORI.'1ATION

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APPLE INC LSE

3000 LAKESIDE DR 2ND FL
BJl.NNOCK 3UR.t"J

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STATEMENT OF FACTS
Complete the appropriate section(s) In full (Including vehicle description) and sign Section H.
VEARIMAl<E

UCENSE PL.AJEJCF NUMBER

7VUZ660

2T2BC1BA2FCOOS381

2015 I Lexus

This transfer Is exempt from use tax because it Is a:

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Family transfer sold between a parent, child, grandparent, grandchild, spouse, domestic partner, or siblings (if both are
minors related by blood or adoption).
Addition or deletion of family member (spouse, domestic partner, parent[s]. son/daughter. grandparents. grandchildren).

0

Gilt (does no\ include vehicles traded between individuals, transfer of contracts or other valuable consideration).
Court Order
0 Inheritance
NOTE: The Use Tax Exemption cannot be claimed If the vehlclelvessel being transferred was purchased from an
otherwise qualifying relative who is engaged In the business of selling the same type of vehlclelvessel.

0

The current market value is:$_ _ _ _ _ __

The vehicle does not require a smog certification for transfer of ownership because:
The last smog certification was obtained within the last 90 days.
It is powered by:
0 electricity
D diesel 0 Other - - - - - - - - -- - It is located outside the State of California. (E)(ception: Nevada and Mex:ico)
0 It is being transferred from/between:
0 The parenl, grandparent, child, grandchild, brother, sister. spouse. or domestic partner (as defined in
Family Code §297) of the transferee. •
0 A sole proprietorship to the proprietor as owner.•
0 Companies whose principal business is leasing vehicles. There is no change in lessee or operator.•
0 Lessor and lessee ot vehicle, and no change in the lessee or operator of the vehicle:
0 Lessor and person who has been lessee's operator of the vehicle tor at least one year. •
0 lndividua!(s) being added as registered owner(s). •
• Does not require smog certification unless Biennial Smog is required .

0
0
0

This vehicle has not been used or parked on a street or highway or off-highway. lam applying for a:
Transfer Only
0 Title Only

0

The vehicle is not currently registered. It has not been driven, moved, towed. or left standing on any California public
highway to cause registration fees to become due. II was not transported over any California public highway or operated
within California to cause off-highway fees to become due. Appropriate registration will be obtained before the vehicle is
operated.

Enter your Disabled Person License Plate, or Disabled Veteran License Plate, or Permanent Disabled Person Parking Placard
number below:
DlSABLED PERSO-'J PLJITE

DISABUO VEl EAAN PLATE

PEIIM,o.NE.NT ClSABLEC PEASON PL.AO.RO

The vehicle to which m Window Decal witt be affixed is:
UC£NS E NU>.<IIER

Mail to:

ClTY

Z1P

 STATEMENT OF FACTS
Complete the appropriate sectlon(s) in full (Including vehicle description) and sign Section H.
UCENSE PI.AlEJCF NU><&fl

7VUZ660

VO<tClE.VliSSEL ID NU"-'8ER

VEJ..R.MAKE

2T2BC1BA2FC008381

2015 I Lexus

E. ...'STATEMENT FOR Vet·liCLE BODY CHANGE (OWNERSHIP CERTIACATE REQUIRED) .
The current market value of the vehicle or vessel Is:
Changes were made at a cost of $ _ _ _ _ _ __
This is what I changed: Check all that apply:
0 Unladen Weighl changed because
0 Motive Power changed from
0 Body Type changed from
0 Number of Axles changed from

S_ _ _ _ _ __
on this d a t e - - - - - - - -

(Public Weighmaster Certificate is required. Exception: Trailers)
to - - - - - - - to------to _ _ _ _ _ __

Please print

0

I.--------------- a n d - - - - - - - - - - - - - - are one and the same person.

0

My name is misspelled. Please correct it t o : - - - - - - - - - - - - - - - - - - - - - - - - - - -

0

I am changing my name from

I, the undersigned, s1ate:

Applicant certifies that the development platforms that it is registering under the CA
DMV Autonomous Vehicle Tester Program will be used solely for the purpose of testing.
During all on-road testing, a trained and alert safety driver will monitor and supplement
the use and controls of the development platform being tested. The development platform
uses hardware and software to monitor surrounding objects and events . The development
platform is capable of sending electronic commands for steering, accelerating, and
decelerating and may carry out portions of the dynamic driving task.

J certify (or declare) under penalty ol perjury under the Jaws of the State of California that the foregoing is true and
correct.
PRINTEO LAST NJ.ME

Kenner
SICi"'AilJRE

riAST lt..WE

D4Yl1ME PHONE NUI.<8EA

Steven

( 408 ) 996-1010
DATE.

X
REC 2~6 1 AEV. 8.'20CS) WWW

 Smog Check Vehicle Inspection Report (VIR)
lnform~rion

\ 'chirlc

Mt'l,.kl Year:
Vl~ ( sc:~nnc<.l

2015
(rnm v.:hiclcl:

LEX LIS
2T20C 113A21-'COO!:J!il
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OH

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Fuel Typ.::

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OJmncro:r:

GVWR:

r•.ooo :mJ kss

763

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R~~ulr

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PASS
Congr.orubti<~ns !
cu•i~<..<ions

Smo~

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from Ihe air. Th:mk ~·uu for lccriug your v.:hick "' Cll rn3inraincd.
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