Get TN Multi-purpose Application Form

Instructions Reset Print TENNESSEE DEPARTMENT OF REVENUE VEHICLE SERVICES DIVISION MULTI-PURPOSE APPLICATION Form instructions are available at http //www. Tn.gov/revenue/forms/titlereg/f1315201inst. pdf or call toll-free at 1 888 871-3171 Monday -Friday 8 00 - 4 30 CST. NEW OR CURRENT TITLE NUMBER TRANSACTION REGISTRATION ONLY NUMBER CODE OWNER INFORMATION LEGAL STATUS 1 AND 2 OR LAST NAME ENTER NAME CODE IN BOX 1 SAME 2 DIFFERENT 3 MULTIPLE LAST NAMES 4 COMPANY 5 OVER 25 CHARACTERS MIDDLE INITIAL FIRST NAME ADDRESS 1 MAILING ADDRESS 2 PHYSICAL STATE CITY CNTY OF RESIDENCE/PRINCIPAL BUS OR INCORP LOCATION ZIP CODE PURCHASE DATE LEASED ILU MAO ADDITIONAL OWNER PLACARD/HEARING IMPAIRED CLS/YR INSURANCE POLICY TELEPHONE SERVICE OPTIONS VEHICLE INFORMATION VIN MODEL MAKE SURRENDERED TITLE BODY YEAR PREVIOUS STATES TITLED COLOR CODE enter appropriate code MOBILE HOME LOWER LGTH UPPER VEHICLE USE VEHICLE TYPE CURRENT MILEAGE AXLES WDTH TITLE BRAND - translation ODOMETER ACTUAL 0 NOT ACTUAL 3 INDICATOR OVER 10 YRS/16 000 LBS. 1 List one IN EXCESS OF MECHANICAL LIMITS 9 VEHICLE TRADE-IN DESCRIPTION GROSS VEHICLE WEIGHT TYPE OF FUEL - translation COMPANY VEHICLE PLATE INFORMATION required for Title and Registration and Registration Only Transactions CLASSCODE/ISSUE YR 1 3 PLATE 1 VALIDATION 1 COUNTY STICKER 1 CITY STICKER 1 2 PLATE TRADE IN 2 CLASS CODE/ISSUE YR 2 EXPIRATION DATE 1 2 3 TEMP OPERATOR PERMIT 3 OF SEATS 5 ZONE COUNTY NAME 6 TDS STICKER 4 USDOT/REGISTRANT 7 MOTOR CARRIER 8 LIEN INFORMATION if lien present FIRST LIENHOLDER LIEN DATE STREET SECOND LIENHOLDER LESSEE/REGISTRANT INFORMATION OWNER OF PLATE NAME CODE LEGAL STATUS NAME ADDRESS VEHICLE COST/TAX INFORMATION required for Title and Registation Transactions SALE PRICE TAXABLE AMOUNT TRADE IN ALLOWANCE DEALER NAME SALES TAX PAID TAX EXEMPTION REASON/SALES TAX DEALER ADDRESS DEALER Required for Duplicate Title - T. C. A. 55-3-115 submit illegible or altered Certificate of Title LOST STOLEN MUTILATED RETURNED DUE TO NON DELIVERY ILLEGIBLE ALTERED Under penalties of perjury I hereby certify all information provided is true and correct to the best of my knowledge and acknowledge that it is not the responsibility of the Vehicle Services Division or its assignees to determine the accuracy of the information provided by me or on my behalf. SIGNATURE OF CERTIFIER/OWNER POWER OF ATTORNEY/AUTHORIZED SIGNATURE IF APPLICABLE X INVOICE NUMBER COUNTY NAME CO NUMBER DATE OF APPLICATION DATE BY AUTHORITY OF REGISTRAR OF MOTOR VEHICLES COUNTY CLERK OFFICE USE ONLY REGISTRATION FEE CREDIT COMPUTATION OF SALES OR USE TAX LOCAL RATE ORGAN DONOR POSTAGE SALES TAX LEASE FEE ADDITIONAL TAX ISSUANCE FEE TITLE FEE TOTAL TAX COLLECTED COLLECTED IN STATE OF COUNTY WHEEL TAX USE TAX SERVICE OPT FEE RV-F1315201 Rev. 8-14 VER ID/RESIDENCY VERIFICATION TOTAL FEES COLLECTED. tn*gov/revenue/forms/titlereg/f1315201inst. pdf or call toll-free at 1 888 871-3171 Monday -Friday 8 00 - 4 30 CST. NEW OR CURRENT TITLE NUMBER TRANSACTION REGISTRATION ONLY NUMBER CODE OWNER INFORMATION LEGAL STATUS 1 AND 2 OR LAST NAME ENTER NAME CODE IN BOX 1 SAME 2 DIFFERENT 3 MULTIPLE LAST NAMES 4 COMPANY 5 OVER 25 CHARACTERS MIDDLE INITIAL FIRST NAME ADDRESS 1 MAILING ADDRESS 2 PHYSICAL STATE CITY CNTY OF RESIDENCE/PRINCIPAL BUS OR INCORP LOCATION ZIP CODE PURCHASE DATE LEASED ILU MAO ADDITIONAL OWNER PLACARD/HEARING IMPAIRED CLS/YR INSURANCE POLICY TELEPHONE SERVICE OPTIONS VEHICLE INFORMATION VIN MODEL MAKE SURRENDERED TITLE BODY YEAR PREVIOUS STATES TITLED COLOR CODE enter appropriate code MOBILE HOME LOWER LGTH UPPER VEHICLE USE VEHICLE TYPE CURRENT MILEAGE AXLES WDTH TITLE BRAND - translation ODOMETER ACTUAL 0 NOT ACTUAL 3 INDICATOR OVER 10 YRS/16 000 LBS* 1 List one IN EXCESS OF MECHANICAL LIMITS 9 VEHICLE TRADE-IN DESCRIPTION GROSS VEHICLE WEIGHT TYPE OF FUEL - translation COMPANY VEHICLE PLATE INFORMATION required for Title and Registration and Registration Only Transactions CLASSCODE/ISSUE YR 1 3 PLATE 1 VALIDATION 1 COUNTY STICKER 1 CITY STICKER 1 2 PLATE TRADE IN 2 CLASS CODE/ISSUE YR 2 EXPIRATION DATE 1 2 3 TEMP OPERATOR PERMIT 3 OF SEATS 5 ZONE COUNTY NAME 6 TDS STICKER 4 USDOT/REGISTRANT 7 MOTOR CARRIER 8 LIEN INFORMATION if lien present FIRST LIENHOLDER LIEN DATE STREET SECOND LIENHOLDER LESSEE/REGISTRANT INFORMATION OWNER OF PLATE NAME CODE LEGAL STATUS NAME ADDRESS VEHICLE COST/TAX INFORMATION required for Title and Registation Transactions SALE PRICE TAXABLE AMOUNT TRADE IN ALLOWANCE DEALER NAME SALES TAX PAID TAX EXEMPTION REASON/SALES TAX DEALER ADDRESS DEALER Required for Duplicate Title - T. .