Get MN DPS PS2025 2018-2024

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 THE FOLLOWING INSTRUCTIONS BEFORE COMPLETING THIS 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 a motor vehicle application PS2000. 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 VEHICLE IDENTIFICATION NUMBER 10 11 12 13 Make Year Model Title Number B Plate Number INCORRECT BUYER S MUST COMPLETE THIS SECTION Incorrect Buyer s Name/Names last first and middle Date s of Birth Signature s INCORRECT BUYER S MUST SIGN X LIEN RELEASE FOR INCORRECT BUYER S - Must be Notarized Secured Party s Name City On provide date Subscribed and sworn to before me this day of 20 State 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 First Secured Party Print Name Date of Loan IN EXCESS OF ODOMETER S MECHANICAL LIMITS FOR ADDITIONAL SECURED PARTIES ATTACH COMPLETED FORM PS2017 DAMAGE DISCLOSURE STATEMENT. TO THE BEST OF MY KNOWLEDGE THIS VEHICLE NO TENTHS MILES NOW READS AND TO THE BEST OF MY KNOWLEDGE THE ODOMETER MILEAGE IS ACTUAL MILEAGE IF YES COMPLETE SECTION BELOW ODOMETER DISCLOSURE STATEMENT. I/WE CERTIFY THAT THE ODOMETER 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 S MUST COMPLETE THIS SECTION I/WE CERTIFY THAT ALL INFORMATION ABOVE IS CORRECT Seller s Full Name Listed Dealer s Full Name Seller s Signature PS2025-B1 05/18. 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 VEHICLE IDENTIFICATION NUMBER 10 11 12 13 Make Year Model Title Number B Plate Number INCORRECT BUYER S MUST COMPLETE THIS SECTION Incorrect Buyer s Name/Names last first and middle Date s of Birth Signature s INCORRECT BUYER S MUST SIGN X LIEN RELEASE FOR INCORRECT BUYER S - Must be Notarized Secured Party s Name City On provide date Subscribed and sworn to before me this day of 20 State Zip Code The secured Party named no longer claims a security interest in the vehicle above. .