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Get MI RD-108 2018-2021

Gap or Waiver X Signature of Dealer s Agent Title 15-Day Temporary Registration Number Printed Name of Person Issuing Temporary Registration Temporary Fee Charged Purchaser Warning Do Not Sign a Blank Form I am purchasing or leasing this vehicle and am applying for a Michigan certificate of title and registration or if the lessee applying for a registration. I certify that my driver s license is not suspended revoked or denied as a repeat offender and I am eligible to purchase or register this vehicle. Total Amount of Finance Contract. vehicle is subject only to the secured interest listed on this form. I certify the Warning This Insurance is not PL/PD No-Fault Insurance required by Michigan law. dealership will apply for title and registration in the purchaser s name within 15 Credit Life Insurance Health Accident Insurance days of the delivery date. Michigan Department of State Application for Title and Registration Statement of Vehicle Sale Purchase Date Stock Number Delivery Date Base MSRP For Department Use Only Plate Number Dealer Plate Expiration Date Month Day New Plate Renewal Year Transfer Street Address City State MI County Dealer License Number Vehicle Sold ZIP Code Used Demo Trade-In Year Trade-In Make Vehicle Identification Number VIN Trade-In Yes No Vehicle Registration to Transfer Plate Fee Category or Weight License Plate Fee Driver s License or PID Number of All Owners or Lessees County of Residence Make County Code Title Fee Complete Names and Address of All Owners or Lessor Expires 15 Days After Delivery Date Plate Transferred From Plate Code Phone Number Sales Tax License Number New Body Style Title Late Fee Sales Tax Temp. Expiration Date Total - Transfer to Line 5 Vehicle History and Title Brand Disclosure Police Vehicle Municipal Vehicle Taxi Vehicle Has Been Flood Damaged Salvage Title Was Previously Issued Odometer Mileage Disclosure The odometer mileage reading must match the mileage reading disclosed to the purchaser on the title or mileage statement. Actual Mileage No Tenths Exempt Dealer Installed Accessories When Optional to Purchaser Full Rights to Survivor Michigan No-Fault Insurance Company Policy or Binder Number Secured Interest Lien Filing Date ELT UID City State ZIP Mail Title Upon Lien Release 1. Purchase Price of Vehicle Including Freight Accessories. 2. Other Taxable Charges Documentary Service Temp* Reg* Fees etc* 3. Trade-in Sales Tax Credit. 4. Total Taxable Price Line 1 Line 2 Line 3. Remarks 5. Sales Tax Plate Fee Title Fee From Total Above. 6. Non-Taxable Charges Labor Service Contract etc*. 7. Total Delivered Price Line 1 Line 2 Line 5 Line 6. 8. Cash on Deposit. 9. Cash Due on Delivery. 10. Trade-In*. 11. Minus Lien*. Recreation Passport Purchaser or Lessee s Initials 12. Total Down Payment. 13. Unpaid Balance to be Financed*. 14. Insurance Premium Charge. I certify this vehicle was delivered to the named purchaser or lessee on the delivery date indicated above all information on this form is accurate and the 15..

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