Transcription of DMV Application for Replacement Title - oregon.gov
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PROPANEGASELECTRICOTHER:DIESELHYBRIDGVWR OVER26,000 #TELEPHONE #( )( )735-515 (1-18)STK# 300164 XXXSIGNATURE OF OWNER, SECURITY INTEREST HOLDER OR LESSORSIGNATURE OF OWNER, SECURITY INTEREST HOLDER OR LESSORDATEDATE1617 SIGNATURE OF PERSON CERTIFYING THE Title IS LOST, DESTROYED, OR MUTILATED, IF NOT AN OWNER SHOWN ON DMV DATE STAMP / INITIALSDATEI hereby request a Replacement Title and certify to the best of my knowledge the Title for this vehicle has been lost, destroyed or mutilated, andto the best of my knowledge has not been signed, conveyed or transferred to another party. (If mutilated, the Title or what remains of the Title isattached.)
Notice of Transaction Submitted Keep in your vehicle until registration card is received. PRINT FULL LEGAL NAME: ,!34 &)234 -)$$,% OF JOINT OWNER OR LESSEE
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