Get MN DPS PS2025 2013
SUITE 165 ST. PAUL MN 55101-5165 Phone 651 297-2126 TTY 651 282-6555 Website dvs. dps. mn.gov AFFIDAVIT TO CORRECT THE OWNERSHIP RECORD OF A MOTOR VEHICLE PLEASE READ INSTRUCTIONS BELOW BEFORE COMPLETING FORM The appropriate parties must complete all sections of this form and the following Titled vehicle The seller s and correct buyer s must also complete the transfer and application on the certificate of title. TO THE BEST OF MY KNOWLEDGE THIS VEHICLE HAS HAS NOT CHECK ONE SUSTAINED DAMAGE IN EXCESS OF 80 PERCENT ACTUAL CASH VALUE. ASSIGNMENT I/WE CERTIFY THAT THIS VEHICLE IS FREE FROM ALL SECURITY INTERESTS. I/WE WARRANT TITLE AND ASSIGN THE REGISTRATION TAX AND VEHICLE TO THE PERSON S NAMED ABOVE. I/WE DID PURCHASE THE ABOVE DESCRIBED VEHICLE SUBJECT TO LIENS SHOW AND NO OTHERS Date of Purchase D SELLER MUST COMPLETE I/WE CERTIFY THAT ALL INFOMRATION ABOVE IS CORRECT Seller s Signature PS2025-E1 07/13. MINNESOTA DEPARTMENT OF PUBLIC SAFETY Print Form DRIVER AND VEHICLE SERVICES DIVISION 445 MINNESOTA ST. Non-titled vehicle A motor vehicle application PS2000 must be completed and signed by the correct buyer. Note To qualify for a refund cancellation of a vehicle sale must be submitted within 90 days of the initial sale date. VEHICLE DESCRIPTION MUST BE COMPLETED IN ALL CASES A Year VEHICLE IDENTIFICATION NUMBER 10 11 12 13 14 Make Model Plate Number Title Number B INCORRECT BUYER S MUST COMPLETE Incorrect Buyer s Name/Names last first and middle Date s of Birth Signature s INCORRECT BUYER S MUST SIGN X On provide date LIEN RELEASE FOR INCORRECT BUYER S - Must be Notarized Secured Party s Name Subscribed and sworn to before me this day of 20 State City Zip Code The secured Party named no longer claims a security interest in the vehicle above. Notary Public County Signature and Title of Authorized Agent Date of Release My Commission Expires Note If a lien is noted on the certificate of title a lien release is required for the incorrect buyer The correct buyer must complete the lien information in section C below. C Buyer s Name/Names last first and middle Street Address IS THIS VEHICLE SUBJECT TO SECURITY AGREEMENT S YES NO Date of Loan First Secured Party Print Name ODOMETER DISCLOSURE STATEMENT. I/WE CERTIFY THAT THE ODOMETER NOW READS NO TENTHS MILES AND TO THE BEST OF MY KNOWLEDGE THE ODOMETER MILEAGE IS ACTUAL MILEAGE WARNING ODOMETER DISCREPNCY MECHANICAL LIMITS IF YES COMPLETE SECTION BELOW FOR ADDITIONAL SECURED PARTIES ATTACH COMPLETED FORM PS2017 DAMAGE DISCLOSURE STATEMENT. Non-titled vehicle A motor vehicle application PS2000 must be completed and signed by the correct buyer. Note To qualify for a refund cancellation of a vehicle sale must be submitted within 90 days of the initial sale date. Note To qualify for a refund cancellation of a vehicle sale must be submitted within 90 days of the initial sale date. VEHICLE DESCRIPTION MUST BE COMPLETED IN ALL CASES A Year VEHICLE IDENTIFICATION NUMBER 10 11 12 13 14 Make Model Plate Number Title Number B INCORRECT BUYER S MUST COMPLETE Incorrect Buyer s Name/Names last first and middle Date s of Birth Signature s INCORRECT BUYER S MUST SIGN X On provide date LIEN RELEASE FOR INCORRECT BUYER S - Must be Notarized Secured Party s Name Subscribed and sworn to before me this day of 20 State City Zip Code The secured Party named no longer claims a security interest in the vehicle above. .
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