Transcription of 6601 Ritchie Highwa y, N.E. VR-217 (05 21 Glen Burnie ...
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6601 Ritchie Highwa y, N.E. VR-217 (05 21 Glen Burnie ...
6601 Ritchie Highway, Glen Burnie , Maryland 21062 For more information, please call: 410-768-7000 (to speak with a customer agent).TTY for the hearing impaired: 1-800-492-4575. Visit our website at: (05-21)Please print or type all information in black to secured party:To perfect your security interest: (Maryland title must accompany two copies of this form)The security interest as set forth below is perfected on date of creation if this statement, filing fee, and any other information required is delivered to the Motor Vehicle Administration within ten days from the date this security interest was created. If delivery is made after the tenth day, the date of perfection is the date received by the Motor Vehicle Note: If the lien holder is anyone other than a bona fide lending institution ( bank, credit union, finance company or dealer), a lien contract must accompany this to be held as collateralYearMake of VehicleBody StyleVehicle Identification NumberMaryland Title NumberType of ContractAccount Number(MVA Use Only) Lien CodeName of Secured PartyDate of CreationAmount of Lien$Street Address of Secured PartyCityCountyStateZip CodeName of DebtorStreet Address of DebtorCityCountyStateZip CodeI (we) certify under penalty of perjury that:A.
Name of Debtor Street Address of Debtor City County State Zip Code I (we) certify under penalty of perjury that: A. The lien holder making application has a Maryland lender’s license or sales finance license issued by the Commissioner of …
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