Username & Password DetailsUsername* Password* Confirm Password*Individual / Organisation DetailsIndividual or Organisation?*IndividualOrganisationTitle*MrMrsMsMissMasterDrProfRevLadySirCapt.MajorLt.-Col.Col.Lt.-Cmdr.The Hon.Cmdr.Flt. Lt.Brgdr.The Hon. MrsWng. Cmdr.Group Capt.Rt. Hon. LordRevd. FatherRevd CanonMaj.-Gen.Air Cdre.DameFirst Name* Last Name* Known As Birth Date Occupation Partners Name Mailer Title Organisation Name Organisation TypeCitroën / DS Sales and ServiceCitroën / DS Sales OnlyCitroën / DS Service OnlyOther Car ClubOther Motoring OrganisationsNot-for-profit OrganisationsOther OrganisationsOrganisation Contact Contact DetailsHome Address*Organisation Postal Address*Suburb Rural Delivery No. Town or City* Post Code* Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwePostal Address same as above?*YesNoPostal Address*Postal Suburb Postal Rural Delivery No. Postal Town or City* Postal Post Code* Postal Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweHome Phone No. Organisation Phone No. Mobile Phone No Work Phone No. E-mail Address* Preferred Contact*EmailMobile PhoneHome PhoneWork PhoneClub Membership DetailsBranch Club*AucklandWaikatoHawkes BayTaranaki West CoastGreater WellingtonCanterburyAccount Type*Member_AucklandMember_WaikatoMember_Hawkes BayMember_Taranaki West CoastMember_Greater WellingtonMember_CanterburyMember Type*PrimarySecondaryLocal Branch Magazine Delivery Method*PostalEmailPostal and EmailDo you want to join another Branch Club?*NoYesAdditional Branch Club-AucklandWaikatoHawkes BayTaranaki West CoastGreater WellingtonCanterburyMember Type Additional ClubPrimarySecondaryBranch Club Magazine Delivery Additional ClubPostalEmailPostal and Email"NZ Citroën" Magazine*YesNoNew Zealand Citroën Magazine Delivery*Postal-PrintedEmail-PDFPostal & EmailNo MagazineNumber of Printed Copies Vehicles 1 and 2 DetailsMake (1st Vehicle)-CitroenDSPanhardBerlietVehicle 1 Model-Pre-TractionTraction2CV and DerivativesID/DSSM and CXCXGS and GSAAX and BXVisaSaxoXM, Xsara and XantiaZXBerlingo, Dispatch, Evasion, Jumper,Nemo and RelayC1,C2,C3,C4,C5 and C6C8Ds3DS4DS5OtherVehilce 1 DS Model-DS3 1.4 SMT ABS D/AB 2WDDS3 1.4I EGSDS3 1.6 VTIDS3 CABIO DSPORT 115KWDS3 DSPORTDS3 DSTYLE 1.6 AUTO 3DRDS4 1.6DS4 1.6 TURBO DIESEL EGSDS4 CROSSBACK 2.0DS4 DSPORT HDIDS4 DSPORTDS4 DSTYLEDS5 1.6 BLUEHDIDS5 1.6I E-HDIDS5 DSPORT 2.0 HDIDS5 HYBRID 4DS5 D SPORTOTHER - add in descriptionVehicle 1 traction-Super Modern 127C RoadsterLight 15 or 11BLBig 15 or 11BCoupéCommercialeBig 6 or15/66HOTHER Add details in DescriptionVehicle 1 ID and DS models-ID19ID 19 comfortID SafariDS 19DS SafariDS 20DS 20 SafariDS 21DS 21 PallasDS 21 SafariDS 23DS 23 PallasDS 23 SafariD SpecialD Super 5OtherVehicle 1 2CV and derivatives-2CV2CV 62CV Special2CV Dolly2CV Charleston2CV BambooAK 350AK 400Dyane 4Dyane 6AcavdianeMehariLomaxAMI 6AMI SuperAMI Super EstateAMI 8AMI 8 EstateVehicle 1 SM and CX-SM 2.7SM 2.7 AUTOSM 2.7 ISM 3.0SM 3.0 AUTOCX 2000CX 2200 TRSCX 2400CX 2400 GTICX 2400 PRESTIGECX 2400 FAMILIALECX 2400 REFLEX FAMILIALECX 2400 PALLASCX 2400 SAFARICX 2000CX 2500CX 2500 GTICX 2500 TGTICX 2500 PRESTIGECX 2500 PRESTIGE TURBOCX 2500 PRESTIGE TURBO 2CX 2500 FAMILIALECX 2500 REFLEX FAMILIALECX 2500 PALLASCX 2500 SAFARICX 2500 DTROTHERVehicle 1 GS and GSA-GS 1220 CLUBGS BREAKGS PALLASGS SPECIALGSA BREAKGSA CLUBGSA PALLASGSA SPECIALGSA XIOTHERVehicle 1 AX and BX Models-AX 10 REAX 11 TREAX 11 TRSAX 14 TRSAX DEBUTAX GT 3 DRAX GT 5 DRAX 15 DBX 14 TGEBX 16 RSBX 16 TGSBX 16 TGS BREAKBX 16 TRSBX 16 TRXBX 16 TZSBX 19 16VBX 19 GTBX 19 GTIBX 19 GTI 16VBX 19 TGDBX 19 TRI AUTOBX 19 TRSBX 19 TXDBX 19 TZSBX 19 TZSBX 19 TZS BREAKBX IMAGE 19 TDBX 19 RD BREAKOTHERVehicle 1 ZX-ZX 1.4I AVANTAGEZX 1.8 AURAZX 1.8 FURIO COUPEZX 1.9 TD BREAKZX 1.9 TDZX VOLCANEZX VOLCANE 2.0I GTIZX 1.9 AURA DIESELOTHERVehicle 1 XM, Xsara and Xantia-XM 2.0IXM 2.0I TURBO BREAKXM 2.0I TURBOXM 2.1 TDXM 2.5 TD VSXXM 3.0 V6XSARAXSARA PICASSOXANTIA 1.9 SX TURBOXANTIA 1.9 X TDXANTIA 1.9 TD BREAKOTHERVehicle 1 C1,C2,C3,C4,C5 and C6-C1 RHYTHM 1.4 HDIC2 1.6 VTS 3DRC2 VTRC2 VTR-SPORTC3 1.4 3DRC3 1.4 SX 5DR PETROLC3 1.4 SX 5DR DIESELC3 1.4 VT 5DR PETROLC3 1.6 3DR PETROLC3 1.6 5DR PETROLC3 1.6 AUTO 5DR PLUSC3 1.6 AUTO 5DR VTRC3 1.6 HDI 5DRC3 1.6 EXCLUSIVE PETROLC3 FEEL 1.2PT/6ATC3 FEEL+ 1.2PT/6ATC3 SHINE 1.2PT/6ATC3 PICASSO DIESELC3 PICASSO VTR+C3 AIRCROSS SHINE 1.2PTC3 AIRCROSS ORIGINS 1.2PTC3 ATTRACTION MANUAL 1.C3 LEATUCR EDITIONC3 SEDUCTION MANUAL 1.6C4 1.6 HDIC4 1.6 SXC4 1.6 TURBOC4 1.6 VTIC4 1.6 VTR COUPEC4 1.6 SEDUCTIONC4 2.0 EX / SXC4 2.0 HDIC4 2.0 SXC4 2.0 VTSC4 AIRCROSS 4WDC4 AIRCROSS 2WDC4 CACTUS 1.2 PURETECHC4 CACTUS E-HDI ETG 1.6D/6AM/HC4 GRAND PICASSO 1.6IC4 GRAND PICASSO 2.0C4 GRAND PICASSO 2.0 HDIC4 PICASSO 1.6 HDI VTR+C4 PICASSO 1.6I EHDIC4 PICASSO VTR HDIC4 PICASSO VTR+C5 1.6 THPC5 1.8 AUTOC5 2.0 SXC5 2.0 HDI SXC5 2.0 HDI EXCLUSIVEC5 2.0 HDI TOURERC5 2.0 HDI COMFORTC5 2.0 HDI LXC5 2.0 HDI VTRC5 3.0 V6 EXCLUSIVEC5 3.0 V6 EXCLUSIVE TOURERC5 3.0 HDI V6 EXCLUSIVEC5 1.6 PT AIRCROSSC5 AIRCROSS SHINEC6 2.7 HDI SALOONC6 EXCLUSIVE HDIC6 LIGNAGE HDIC6 3.0 HDIOTHERVehicle 1 Berlingo, Dispatch, Evasion, Jumper, Nemo and Relay-Berlingo 1.4 FG600 VAN 5spM PBerlingo 1.9 FG800 VAN 5SPM DBerlingo 1.4 FG800 3DR 5SP MBerlingo 1.6 HDI MANUALBerlingo MULTISPACE 1.6HBerlingo LWB 1.6L EHDIDISPATCHEVASIONJUMPER ILUSION IRIUS 730JUMPER ILUSIONJUMPER KASTEN RELAYJUMPER ILUSION 760NEMORELAY 35 ENTERPRISE HDIRELAY 35 HDIRELAY 35 L3 H2 2.2 HDIRELAY 35 L3H2 ENTERPRISEOTHERColour Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919Registration Plate Vehicle 1 Additional CommentsOwner (if different from applicant) Add a 2nd vehicle?NoYesMake (2nd Vehicle)-CitroenDSPanhardBerlietVehicle 2 Model-Pre-TractionTraction2CV and DerivativesID/DSSM and CXCXGS and GSAAX and BXVisaSaxoXM, Xsara and XantiaZXBerlingo, Dispatch, Evasion, Jumper,Nemo and RelayC1,C2,C3,C4,C5 and C6C8Ds3DS4DS5OtherVehicle 2 Model DS-DS3 1.4 SMT ABS D/AB 2WDDS3 1.4I EGSDS3 1.6 VTIDS3 CABIO DSPORT 115KWDS3 DSPORTDS3 DSTYLE 1.6 AUTO 3DRDS4 1.6DS4 1.6 TURBO DIESEL EGSDS4 CROSSBACK 2.0DS4 DSPORT HDIDS4 DSPORTDS4 DSTYLEDS5 1.6 BLUEHDIDS5 1.6I E-HDIDS5 DSPORT 2.0 HDIDS5 HYBRID 4DS5 D SPORTOTHERVehicle 2 Traction-Super Modern 127C RoadsterLight 15 or 11BLBig 15 or 11BCoupéCommercialeBig 6 or15/66HOTHER Add details in DescriptionVehicle 1 ID and DS models-ID19ID 19 comfortID SafariDS 19DS SafariDS 20DS 20 SafariDS 21DS 21 PallasDS 21 SafariDS 23DS 23 PallasDS 23 SafariD SpecialD Super 5OtherVehicle 2 2CV and derivatives-2CV2CV 62CV Special2CV Dolly2CV Charleston2CV BambooAK 350AK 400Dyane 4Dyane 6AcavdianeMehariLomaxAMI 6AMI SuperAMI Super EstateAMI 8AMI 8 EstateOTHERVehicle 2 SM and CX-SM 2.7SM 2.7 AUTOSM 2.7 ISM 3.0SM 3.0 AUTOCX 2000CX 2200 TRSCX 2400CX 2400 GTICX 2400 PRESTIGECX 2400 FAMILIALECX 2400 REFLEX FAMILIALECX 2400 PALLASCX 2400 SAFARICX 2000CX 2500CX 2500 GTICX 2500 TGTICX 2500 PRESTIGECX 2500 PRESTIGE TURBOCX 2500 PRESTIGE TURBO 2CX 2500 FAMILIALECX 2500 REFLEX FAMILIALECX 2500 PALLASCX 2500 SAFARICX 2500 DTROTHERVehicle 2 GS and GSA-GS 1220 CLUBGS BREAKGS PALLASGS SPECIALGSA BREAKGSA CLUBGSA PALLASGSA SPECIALGSA XIOTHERVehicle 2 AX and BX-AX 10 REAX 11 TREAX 11 TRSAX 14 TRSAX DEBUTAX GT 3 DRAX GT 5 DRAX 15 DBX 14 TGEBX 16 RSBX 16 TGSBX 16 TGS BREAKBX 16 TRSBX 16 TRXBX 16 TZSBX 19 16VBX 19 GTBX 19 GTIBX 19 GTI 16VBX 19 TGDBX 19 TRI AUTOBX 19 TRSBX 19 TXDBX 19 TZSBX 19 TZSBX 19 TZS BREAKBX IMAGE 19 TDBX 19 RD BREAKOTHERVehicle 2 ZX-ZX 1.4I AVANTAGEZX 1.8 AURAZX 1.8 FURIO COUPEZX 1.9 TD BREAKZX 1.9 TDZX VOLCANEZX VOLCANE 2.0I GTIZX 1.9 AURA DIESELOTHERVehicle 2 XM, Xsara and Xantia-XM 2.0IXM 2.0I TURBO BREAKXM 2.0I TURBOXM 2.1 TDXM 2.5 TD VSXXM 3.0 V6XSARAXSARA PICASSOXANTIA 1.9 SX TURBOXANTIA 1.9 X TDXANTIA 1.9 TD BREAKOTHERVehicle 2 C1,C2,C3,C4.C5 and C6-C1 RHYTHM 1.4 HDIC2 1.6 VTS 3DRC2 VTRC2 VTR-SPORTC3 1.4 3DRC3 1.4 SX 5DR PETROLC3 1.4 SX 5DR DIESELC3 1.4 VT 5DR PETROLC3 1.6 3DR PETROLC3 1.6 5DR PETROLC3 1.6 AUTO 5DR PLUSC3 1.6 AUTO 5DR VTRC3 1.6 HDI 5DRC3 1.6 EXCLUSIVE PETROLC3 FEEL 1.2PT/6ATC3 FEEL+ 1.2PT/6ATC3 SHINE 1.2PT/6ATC3 PICASSO DIESELC3 PICASSO VTR+C3 AIRCROSS SHINE 1.2PTC3 AIRCROSS ORIGINS 1.2PTC3 ATTRACTION MANUAL 1.C3 LEATUCR EDITIONC3 SEDUCTION MANUAL 1.6C4 1.6 HDIC4 1.6 SXC4 1.6 TURBOC4 1.6 VTIC4 1.6 VTR COUPEC4 1.6 SEDUCTIONC4 2.0 EX / SXC4 2.0 HDIC4 2.0 SXC4 2.0 VTSC4 AIRCROSS 4WDC4 AIRCROSS 2WDC4 CACTUS 1.2 PURETECHC4 CACTUS E-HDI ETG 1.6D/6AM/HC4 GRAND PICASSO 1.6IC4 GRAND PICASSO 2.0C4 GRAND PICASSO 2.0 HDIC4 PICASSO 1.6 HDI VTR+C4 PICASSO 1.6I EHDIC4 PICASSO VTR HDIC4 PICASSO VTR+C5 1.6 THPC5 1.8 AUTOC5 2.0 SXC5 2.0 HDI SXC5 2.0 HDI EXCLUSIVEC5 2.0 HDI TOURERC5 2.0 HDI COMFORTC5 2.0 HDI LXC5 2.0 HDI VTRC5 3.0 V6 EXCLUSIVEC5 3.0 V6 EXCLUSIVE TOURERC5 3.0 HDI V6 EXCLUSIVEC5 1.6 PT AIRCROSSC5 AIRCROSS SHINEC6 2.7 HDI SALOONC6 EXCLUSIVE HDIC6 LIGNAGE HDIC6 3.0 HDIOTHERVehicle 2 Berlingo, Dispatch, Evasion, Jumper, Nemo and Relay-Berlingo 1.4 FG600 VAN 5spM PBerlingo 1.9 FG800 VAN 5SPM DBerlingo 1.4 FG800 3DR 5SP MBerlingo 1.6 HDI MANUALBerlingo MULTISPACE 1.6HBerlingo LWB 1.6L EHDIDISPATCHEVASIONJUMPER ILUSION IRIUS 730JUMPER ILUSIONJUMPER KASTEN RELAYJUMPER ILUSION 760NEMORELAY 35 ENTERPRISE HDIRELAY 35 HDIRELAY 35 L3 H2 2.2 HDIRELAY 35 L3H2 ENTERPRISEOTHERColour Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919Registration Plate Vehicle 2 DescriptionOwner (if different from applicant) Add a 3rd Vehicle?NoYesVehicle 3,4 and 3 DetailsMake (3rd Vehicle)-CitroenDSPanhardBerlietVehicle 3 Model-1-(A-C) Acadiane – C32-(C-D) C4 – Dyane3-(E-S) EVASION - SM4-(S-Z) TRACTION - ZXModel DS-DS3 1.4 SMT ABS D/AB 2WDDS3 1.4I EGSDS3 1.6 VTIDS3 CABIO DSPORT 115KWDS3 DSPORTDS3 DSTYLE 1.6 AUTO 3DRDS4 1.6DS4 1.6 TURBO DIESEL EGSDS4 CROSSBACK 2.0DS4 DSPORT HDIDS4 DSPORTDS4 DSTYLEDS5 1.6 BLUEHDIDS5 1.6I E-HDIDS5 DSPORT 2.0 HDIDS5 HYBRID 4DS5 D SPORTOTHERVehicle 3 Acadiane - C3-AcadianeAMI 6 / AMI SuperAMI Super EstateAMI 8AMI 8 EstateAX 10 REAX 11 TRE/TRSAX 14 TRSAX GT 3 DR /5 DRAX DEBUTBerlingo 1.4 / 1.9 FG600 /FG800 VANBerlingo 1.6 HDIBerlingo MULTISPACE 1.6HC1 RHYTHM 1.4 HDIC2 1.6 VTR / VTS / VTRT SPORT 3DRC3 1.4 3DRC3 1.4 SX/VT 5DR PC3 1.4 SX 5DR DC3 1.6 3DR PC3 1.6 PLUS/VTR/EXCLUSIVE 5DR PC3 1.6 HDI 5DRC3 1.2 FEEL / FEEL+C3 1.2 SHINEC3 PICASSO DIESEL / VTR+C3 1.2 AIRCROSS SHINE / ORIGINSC3 1.2 ATTRACTION/ SEDUCTIONVehicle 3 C4 - Dyane-C4 1.6 SX / HDIC4 1.6 VIT / TURBOC4 1.6 VTR COUPEC4 1.6 SEDUCTIONC4 2.0 EX / SX / VTS /HDI / VTSC4 AIRCROSS 2WD / 4WDC4 1.2 CACTUSC4 1.6 E-HDI CACTUSC4 GRAND PICASSO 1.6I / 2.0 / 2.0 HDIC4 PICASSO 1.6 E-HDI / HDI VTR / VTR+C5 1.6 THPC5 1.8C5 2.0 SXC5 2.0 HDI LX / SX / VTR / EXCLUSIVE / COMFORTC5 2.0 HDI TOURERC5 3.0 V6 EXCLUSIVE / TOURERC5 1.6 PT AIRCROSS SHINEC6 2.7 HDI EXCLUSIVEC6 LIGNAGE HDIC6 3.0 HDIDS 19 / DS20DS Safari / DS20 SAFARIDS 21 / DS21 PALLASDS 21 SafariDS 23 / DS23 PALLASDS 23 SafariD Special / D Super 5DISPATCHDyane 4 / Dyane 6OTHERVehicle 3 Evasion - SM-EVASIONJUMPER ILUSION / KASTEN / RELAYNEMOGS 1220 CLUBGS PALLAS / SPECIALGS / GSA A BREAKGSA CLUB / PALLAS / SPECIALGSA XIID19 / ID COMFORTID SafariHY VANLomaxMehariRELAY 35RELAY 35 HDISM 2.7SM 2.7 AUTOSM 2.7 ISM 3.0OTHERVehicle 3 Traction - ZX-Super Modern 127C RoadsterLight 15 or 11BLBig 15 or 11BCoupéCommercialeBig 6 or15/66HXM 2.0I / 2.01 TURBOXM 2.0I TURBO BREAKXM 2.1 TD VSXXM 3.0 V6XSARAXSARA PICASSOXANTIA 1.9 SX TURBOXANTIA 1.9 X TDXANTIA 1.9 TD BREAKZX 1.4I AVANTAGEZX 1.8 AURAZX 1.8 FURIO COUPEZX 1.9 TD BREAKOTHERColour Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919Registration Plate Vehicle 3 Additional CommentsOwner (if different from applicant) Add a 4th vehicle?NoYesMake (4th Vehicle)-CitroenDSPanhardBerlietVehilce 4 Model-1-(A-C) Acadiane – C32-(C-D) C4 – Dyane3-(E-S) EVASION - SM4-(S-Z) TRACTION - ZXVehicle 4 Model DS-DS3 1.4 SMT ABS D/AB 2WDDS3 1.4I EGSDS3 1.6 VTIDS3 CABIO DSPORT 115KWDS3 DSPORTDS3 DSTYLE 1.6 AUTO 3DRDS4 1.6DS4 1.6 TURBO DIESEL EGSDS4 CROSSBACK 2.0DS4 DSPORT HDIDS4 DSPORTDS4 DSTYLEDS5 1.6 BLUEHDIDS5 1.6I E-HDIDS5 DSPORT 2.0 HDIDS5 HYBRID 4DS5 D SPORTOTHERVehicle 4 Acadiane - C3-AcadianeAMI 6 / AMI SuperAMI Super EstateAMI 8AMI 8 EstateAX 10 REAX 11 TRE/TRSAX 14 TRSAX GT 3 DR /5 DRAX DEBUTBerlingo 1.4 / 1.9 FG600 /FG800 VANBerlingo 1.6 HDIBerlingo MULTISPACE 1.6HC1 RHYTHM 1.4 HDIC2 1.6 VTR / VTS / VTRT SPORT 3DRC3 1.4 3DRC3 1.4 SX/VT 5DR PC3 1.4 SX 5DR DC3 1.6 3DR PC3 1.6 PLUS/VTR/EXCLUSIVE 5DR PC3 1.6 HDI 5DRC3 1.2 FEEL / FEEL+C3 1.2 SHINEC3 PICASSO DIESEL / VTR+C3 1.2 AIRCROSS SHINE / ORIGINSC3 1.2 ATTRACTION/ SEDUCTIONOTHERVehicle 4 C4 - Dyane--C4 1.6 SX / HDIC4 1.6 VIT / TURBOC4 1.6 VTR COUPEC4 1.6 SEDUCTIONC4 2.0 EX / SX / VTS /HDI / VTSC4 AIRCROSS 2WD / 4WDC4 1.2 CACTUSC4 1.6 E-HDI CACTUSC4 GRAND PICASSO 1.6I / 2.0 / 2.0 HDIC4 PICASSO 1.6 E-HDI / HDI VTR / VTR+C5 1.6 THPC5 1.8C5 2.0 SXC5 2.0 HDI LX / SX / VTR / EXCLUSIVE / COMFORTC5 2.0 HDI TOURERC5 3.0 V6 EXCLUSIVE / TOURERC5 1.6 PT AIRCROSS SHINEC6 2.7 HDI EXCLUSIVEC6 LIGNAGE HDIC6 3.0 HDIDS 19 / DS20DS Safari / DS20 SAFARIDS 21 / DS21 PALLASDS 21 SafariDS 23 / DS23 PALLASDS 23 SafariD Special / D Super 5DISPATCHDyane 4 / DyaneOTHERVehicle 4 Evasion - SM-EVASIONJUMPER ILUSION / KASTEN / RELAYNEMOGS 1220 CLUBGS PALLAS / SPECIALGS / GSA A BREAKGSA CLUB / PALLAS / SPECIALGSA XIID19 / ID COMFORTID SafariHY VANLomaxMehariRELAY 35RELAY 35 HDISM 2.7SM 2.7 AUTOSM 2.7 ISM 3.0OTHERVehicle 4 Traction - ZX-Super Modern 127C RoadsterLight 15 or 11BLBig 15 or 11BCoupéCommercialeBig 6 or15/66HXM 2.0I / 2.01 TURBOXM 2.0I TURBO BREAKXM 2.1 TD VSXXM 3.0 V6XSARAXSARA PICASSOXANTIA 1.9 SX TURBOXANTIA 1.9 X TDXANTIA 1.9 TD BREAKZX 1.4I AVANTAGEZX 1.8 AURAZX 1.8 FURIO COUPEZX 1.9 TD BREAKOTHERColour Year2021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919Registration Plate Vehicle 4 Additional CommentsOwner (if different from applicant) Add a 5th Vehicle?NoYesVehicle 5A Make-CitroenDSPanhardBerlietVehicle 5 Model-1-(A-C) Acadiane – C32-(C-D) C4 – Dyane3-(E-S) EVASION - SM4-(S-Z) TRACTION - ZXVehicle 5 Model DS-DS3 1.4 SMT ABS D/AB 2WDDS3 1.4I EGSDS3 1.6 VTIDS3 CABIO DSPORT 115KWDS3 DSPORTDS3 DSTYLE 1.6 AUTO 3DRDS4 1.6DS4 1.6 TURBO DIESEL EGSDS4 CROSSBACK 2.0DS4 DSPORT HDIDS4 DSPORTDS4 DSTYLEDS5 1.6 BLUEHDIDS5 1.6I E-HDIDS5 DSPORT 2.0 HDIDS5 HYBRID 4DS5 D SPORTOTHERVehicle 5 Acadiane - C3-AcadianeAMI 6 / AMI SuperAMI Super EstateAMI 8AMI 8 EstateAX 10 REAX 11 TRE/TRSAX 14 TRSAX GT 3 DR /5 DRAX DEBUTBerlingo 1.4 / 1.9 FG600 /FG800 VANBerlingo 1.6 HDIBerlingo MULTISPACE 1.6HC1 RHYTHM 1.4 HDIC2 1.6 VTR / VTS / VTRT SPORT 3DRC3 1.4 3DRC3 1.4 SX/VT 5DR PC3 1.4 SX 5DR DC3 1.6 3DR PC3 1.6 PLUS/VTR/EXCLUSIVE 5DR PC3 1.6 HDI 5DRC3 1.2 FEEL / FEEL+C3 1.2 SHINEC3 PICASSO DIESEL / VTR+C3 1.2 AIRCROSS SHINE / ORIGINSC3 1.2 ATTRACTION/ SEDUCTIONOTHERVehicle 5 2 C-D--C4 1.6 SX / HDIC4 1.6 VIT / TURBOC4 1.6 VTR COUPEC4 1.6 SEDUCTIONC4 2.0 EX / SX / VTS /HDI / VTSC4 AIRCROSS 2WD / 4WDC4 1.2 CACTUSC4 1.6 E-HDI CACTUSC4 GRAND PICASSO 1.6I / 2.0 / 2.0 HDIC4 PICASSO 1.6 E-HDI / HDI VTR / VTR+C5 1.6 THPC5 1.8C5 2.0 SXC5 2.0 HDI LX / SX / VTR / EXCLUSIVE / COMFORTC5 2.0 HDI TOURERC5 3.0 V6 EXCLUSIVE / TOURERC5 1.6 PT AIRCROSS SHINEC6 2.7 HDI EXCLUSIVEC6 LIGNAGE HDIC6 3.0 HDIDS 19 / DS20DS Safari / DS20 SAFARIDS 21 / DS21 PALLASDS 21 SafariDS 23 / DS23 PALLASDS 23 SafariD Special / D Super 5DISPATCHDyane 4 / DyaneOTHERVehicle 5 3 E-S-EVASIONJUMPER ILUSION / KASTEN / RELAYNEMOGS 1220 CLUBGS PALLAS / SPECIALGS / GSA A BREAKGSA CLUB / PALLAS / SPECIALGSA XIID19 / ID COMFORTID SafariHY VANLomaxMehariRELAY 35RELAY 35 HDISM 2.7SM 2.7 AUTOSM 2.7 ISM 3.0OTHERVehicle 5 4 T-Z-Super Modern 127C RoadsterLight 15 or 11BLBig 15 or 11BCoupéCommercialeBig 6 or15/66HXM 2.0I / 2.01 TURBOXM 2.0I TURBO BREAKXM 2.1 TD VSXXM 3.0 V6XSARAXSARA PICASSOXANTIA 1.9 SX TURBOXANTIA 1.9 X TDXANTIA 1.9 TD BREAKZX 1.4I AVANTAGEZX 1.8 AURAZX 1.8 FURIO COUPEZX 1.9 TD BREAKOTHERVehicle 5 colour Year20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919Registration Plate Vehicle 5 DescriptionOwner (if different from applicant) Only fill in if you are not human Login