Transcription of TITLE AND REGISTRATION APPLICATION
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TITLE AND REGISTRATION APPLICATION
Plate Number Plate Credit No. Credit Eff. Date First Registered Reg. Eff. Date Reg. Expiration Date Unit Number Mobile Home W/L Vehicle Identification Number Make Body Style Year Model List Price $ GVW Fuel Odometer Reading (no tenths) Odometer Codes* A B C Vehicle Construction Specially Constructed Reconstructed Trailer Plate Size Full Size Small Lien Amount $ Lien Date Additional lien or lienholders (attach another APPLICATION )Lienholder Driver License or EIN* Lienholder Name (if no lien, write NONE) Legal Status Or And And/OrMailing Address City State Zip Owner Driver License or EIN* Owner Name (first, middle, last, suffix) Date of Birth MVD Tax Account Number (if applicable)
I certify that the information above and any documentation which I submit in support of this application, is true and correct; that the vehicle is free from liens, except ... In the event of the death of either party, the interest of the deceased party must be handled ... VA Grant – You received financial aid from the U.S. Department of ...
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