REPOSSESSION OF VEHICLE TITLED OUT-OF-STATE

VSA 98 (04/03/2013) Purpose: A lienholder or lienholder's authorized agent uses this form to apply for a Virginia REPOSSESSION title (in the lienholder's name) for a repossessed VEHICLE that was TITLED in another state. Instructions: Lienholders must complete all sections of this form. Use the State of Title/Requirements table on the back of this form to indicate the state in which the VEHICLE is TITLED and to identify all of the required documents that must be submitted. Mail completed form and required documents, along with the Application for Certificate of Title and Registration (VSA 17A), to the Titling Work Center at the address above or present to any DMV Customer Service Center. Any willful misinformation given with fraudulent intent may be punishable as provided by law. I hereby certify and affirm under penalty of perjury that the information contained in this application, both front and back, is true and correct to the best of my knowledge; that this VEHICLE is in my possession with the intent of offering it for sale in Virginia; and that I have met the requirements of all statutes in the State of Title for this motor VEHICLE , including the requirements indicated for that state in the State of Title/Requirements section of this form.

VSA 98 (04/03/2013) None None. Massachusetts 20145, Notarized. Michigan TR-10 . Minnesota PS2024 . Mississippi 78-012 OR. Missouri DOR 5005. Montana MV-11 OR

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