Get 2012 tc 96 187 2013-2024

TC 96 187 December 2013 Kentucky Transportation Cabinet Division of Motor Vehicle Licensing TITLE LIEN STATEMENT ORIGINAL FILING 1. Debtor s Last Name First and Address CONTINUATION TERMINATION Original File Original File Date 2. Secured Party Name and Address 3. For Filing Officer Date Time Number and Filing Officer 4. Vehicle information YEAR MODEL MAKE VEHICLE IDENTIFICATION NUMBER ADDITIONAL DESCRIPTION NOTE 1 This is a multi-purpose form that can only be used once. A new form must be completed by the Secured Party upon amendment continuation assignment or termination* A termination statement must be signed by the secured party. 2 In compliance with KRS 186A. 190 2 the notation of security interests relating to property required to be titled in Kentucky through the county clerk shall be done in the office of the county clerk of the county in which the debtor resides. Additional information regarding the required county of residence can be found in subsections a-j of KRS 186A. 190 2. Authentication of Debtor s Required for filing a termination Date Optional for County clerk use Date Time Processed Fees Collected Clerks initials. Debtor s Last Name First and Address CONTINUATION TERMINATION Original File Original File Date 2. Secured Party Name and Address 3. For Filing Officer Date Time Number and Filing Officer 4. Vehicle information YEAR MODEL MAKE VEHICLE IDENTIFICATION NUMBER ADDITIONAL DESCRIPTION NOTE 1 This is a multi-purpose form that can only be used once. For Filing Officer Date Time Number and Filing Officer 4. Vehicle information YEAR MODEL MAKE VEHICLE IDENTIFICATION NUMBER ADDITIONAL DESCRIPTION NOTE 1 This is a multi-purpose form that can only be used once. A new form must be completed by the Secured Party upon amendment continuation assignment or termination* A termination statement must be signed by the secured party. A new form must be completed by the Secured Party upon amendment continuation assignment or termination* A termination statement must be signed by the secured party. 2 In compliance with KRS 186A. 190 2 the notation of security interests relating to property required to be titled in Kentucky through the county clerk shall be done in the office of the county clerk of the county in which the debtor resides. 2 In compliance with KRS 186A. 190 2 the notation of security interests relating to property required to be titled in Kentucky through the county clerk shall be done in the office of the county clerk of the county in which the debtor resides. Additional information regarding the required county of residence can be found in subsections a-j of KRS 186A. Additional information regarding the required county of residence can be found in subsections a-j of KRS 186A. 190 2. Authentication of Debtor s Required for filing a termination Date Optional for County clerk use Date Time Processed Fees Collected Clerks initials. Debtor s Last Name First and Address CONTINUATION TERMINATION Original File Original File Date 2. Secured Party Name and Address 3. For Filing Officer Date Time Number and Filing Officer 4. Vehicle information YEAR MODEL MAKE VEHICLE IDENTIFICATION NUMBER ADDITIONAL DESCRIPTION NOTE 1 This is a multi-purpose form that can only be used once. A new form must be completed by the Secured Party upon amendment continuation assignment or termination* A termination statement must be signed by the secured party. .