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Get MD VR-091 2013

Glen Burnie Maryland 21062 Motor Vehicle Administration 6601 Ritchie Highway N.E. VR-091 11-13 Certification of Non-Receipt of Original/Duplicate Title Certificate This application must be accompanied by a copy of the valid state issued identification s of the vehicle owner s and any person presenting the application. Please type or print in black ink except signature. I/we certify that the original/duplicate title certificate applied for in the name s below was never received* Owner s Name - First Middle Last Co-Owner s Name - First Street Address City County Make of Vehicle State Zip Code Vehicle Identification Number Title Number I/we fully understand that the issuance of this duplicate title certificate at no cost to me will nullify all title certificates issued previously in my/our name s covering the above described vehicle. I/we further certify that should the original title described come into my/our possession at any time I/we will return it immediately to the Motor Vehicle Administration for cancellation* Owner s Signature Date Co-Owner s Signature If jointly owned all owners signatures are required* If the owner is a business entity the person legally authorized to sign must state their capacity after their signature. Approved by For more information please call 410-768-7000 to speak with a customer agent. TTY for the hearing impaired 1-800-492-4575. I/we certify that the original/duplicate title certificate applied for in the name s below was never received* Owner s Name - First Middle Last Co-Owner s Name - First Street Address City County Make of Vehicle State Zip Code Vehicle Identification Number Title Number I/we fully understand that the issuance of this duplicate title certificate at no cost to me will nullify all title certificates issued previously in my/our name s covering the above described vehicle. I/we further certify that should the original title described come into my/our possession at any time I/we will return it immediately to the Motor Vehicle Administration for cancellation* Owner s Signature Date Co-Owner s Signature If jointly owned all owners signatures are required* If the owner is a business entity the person legally authorized to sign must state their capacity after their signature. I/we further certify that should the original title described come into my/our possession at any time I/we will return it immediately to the Motor Vehicle Administration for cancellation* Owner s Signature Date Co-Owner s Signature If jointly owned all owners signatures are required* If the owner is a business entity the person legally authorized to sign must state their capacity after their signature. Approved by For more information please call 410-768-7000 to speak with a customer agent. TTY for the hearing impaired 1-800-492-4575. I/we certify that the original/duplicate title certificate applied for in the name s below was never received* Owner s Name - First Middle Last Co-Owner s Name - First Street Address City County Make of Vehicle State Zip Code Vehicle Identification Number Title Number I/we fully understand that the issuance of this duplicate title certificate at no cost to me will nullify all title certificates issued previously in my/our name s covering the above described vehicle. I/we further certify that should the original title described come into my/our possession at any time I/we will return it immediately to the Motor Vehicle Administration for cancellation* Owner s Signature Date Co-Owner s Signature If jointly owned all owners signatures are required* If the owner is a business entity the person legally authorized to sign must state their capacity after their signature. Approved by For more information please call 410-768-7000 to speak with a customer agent. TTY for the hearing impaired 1-800-492-4575. .

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