Application For Certificate of Ownership: Tenths
Application For Certificate of Ownership: Tenths
Application For Certificate of Ownership: Tenths
COMPLETE VEHICLE IDENTIFICATION NUMBER (NOT THE MOTOR NUMBER) NO. OF AXLES
I
ODOMETER READING
TENTHS
PLEASE C H E C K
"YES" OR " N O " Does your vehicle now have a lien? (Is your vehicle financed?) Yes No
If you checked "yes" PRINT name and address of bank or finance company below. If you checked "No", print 'NONE" in the box below.
LIENHOLDER
LIENHOLDER CORPCODE
STREET
NAME
STREET
STATEMENT OF APPLICANT(S): The undersigned hereby certifies all of the above to be true and correct and that the identification
number shown on this form has been compared to the identification number on the motor vehicle and further certifies that they agree
in every particular.
SIGN SIGN
HERE x HERE x
OWNER DATE CO-OWNER (if any) DATE
SIGN SIGN
HERE x HERE x
CO-OWNER (if any) DATE CO-OWNER (if any) DATE
OS/SS-7 (R2/09)