Transcription of 08 DATE VEHICLE PURCHASED TYPE
1 (DO NOT WRITE, MARK, OR STAMP ABOVE THIS LINE)DATETITLE VEHICLE PURCHASEDMOBILE HOMEMAKEYEARLENGTHWIDTHMODELBODY TYPELAST NAMEFIRST NAMEMIDDLE INITIALLAST NAMEFIRST NAMEMIDDLE INITIALSTREET ADDRESSCITYSTATEZIP CODENAME OF LIENHOLDERSTREET ADDRESSCITYSTATEZIP CODEDATE OF DISCHARGEPRINTED NAME (Representative of Lienholder)SIGNATURE (Representative of Lienholder)DATENOTICE TO LIENHOLDER Submit this document or a copy of the front of the Certificate of Title reflecting the release of lien within 72 hours of dischargeto the Taxpayer and VEHICLE Services Division, 44 Vantage Way, Suite 160, Nashville, Tn 37243-8050. Second, deliver the Certificate of Title to the person entitled to it with your notation of discharge of Lien indicated. Failure tocomply with the above constitutes a misdemeanor under the provisions of Section 55-3-127 MUST BE PRINTED OR TYPEWRITTEN IN BLACKRV-F1310901 TENNESSEE DEPARTMENT OF REVENUERDA-692 NOTICE OF discharge OF LIEN
