Transcription of Lien Entry Form - Oklahoma
1 Oklahoma Tax CommissionMotor Vehicle DivisionPost Office Box 269061 Oklahoma City, Oklahoma 73126 Lien Entry FormDebtor Names and Address (Last Name First)this lien Entry form covers the following vehicleLender must type and print four (4) identical copies of the Lien Entry form . Type one Lien Entry form for each vehicle, boat or outboard (s)_____Address_____City, State, Zip _____ _____Secured Party Name Assignee of Secured Party Name_____ _____Address Address_____ _____City, State, Zip City, State, Zip_____ _____ _____ _____ Year Make Body Type Vehicle Identification Number (VIN/HIN)
2 _____ _____ Date of Security Agreement Original Oklahoma Title Number_____ _____ Secured Party/Assignee Signature Date ExecutedForm MV-21-ARevised 10-2016 MVCFees (vehicles)Lien Entry Fee ..$ Fee ..$ Fee ..$ ..$ (boats/motors)Lien Entry Fee ..$ Fee ..$ Fee ..$ ..$ Only FilingLien Entry Fee ..$ Fee ..$ ..$
