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Get UT TC-123 2011

Clear form Application For Utah Duplicate Title TC-123 Rev. 8/11 6. 00 Fee Required Get forms online - tax. Utah. gov Division of Motor Vehicles PO Box 30412 Salt Lake City UT 84130 Telephone 801-297-7780 or 1-800-368-8824 Part 1 - Application for Duplicate Utah Title Missing altered or incorrect information may result in rejected application. Section 1 - Owner Information Primary owner s name last first middle initial or business name Co-owner s name if at different street address check here and list on back Street address primary owner City State ZIP code Mailing address if different from street address primary owner Section 2 - Vehicle Information Vehicle/Hull Identification Number VIN/HIN Year Make Model I certify that the original certificate of title for this vehicle has been lost stolen mutilated or made illegible and has not been endorsed and delivered to a transferee pledged as collateral or delivered to a lending institution. I here by make application for a duplicate certificate of title and agree to indemnify the Utah StateTax Commission and all persons acting under its direction from any and all liability and shall defend at my expense all litigation which may arise as a result of the issuance of the duplicate certificate of title. Owner s signature Date Co-owner s signature X Section 4 - Lien Holder Information and Lien Release Lien holder s name last first middle initial or business name Signature of lien holder releasing interest Title Part 2 - Assignment and Release of Interest Section 1 - Odometer Disclosure and Reassignment of Title Date of sale Reflects actual mileage for this vehicle Reflects the mileage in excess of the odometer s mechanical limits Enter odometer reading no tenths Sale price Is not the actual mileage. Warning - Odometer Discrepancy As owner I hereby transfer all rights title and interest to this vehicle to the new owner named below. I certify to the best of my knowledge that the title is free and clear of encumbrances except the lien to the new lien holder if any. I certify that the odometer and sales information provided is correct and that any brand information recorded on the previous certificate of title has been disclosed to the new owner and lien holder on form TC-814. Section 2 - New Owner and Lien Holder Information New owner s name last first middle initial or business name New lien holder s name last first middle initial or business name New owner s signature. Owner s signature Date Co-owner s signature X Section 4 - Lien Holder Information and Lien Release Lien holder s name last first middle initial or business name Signature of lien holder releasing interest Title Part 2 - Assignment and Release of Interest Section 1 - Odometer Disclosure and Reassignment of Title Date of sale Reflects actual mileage for this vehicle Reflects the mileage in excess of the odometer s mechanical limits Enter odometer reading no tenths Sale price Is not the actual mileage. Warning - Odometer Discrepancy As owner I hereby transfer all rights title and interest to this vehicle to the new owner named below. .

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