Affidavit Of Repossession Minnesota PDF Details

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QuestionAnswer
Form NameAffidavit Of Repossession Minnesota
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesminnesota repossession application, repossession forms, minnesota repossession title, repossession title application form

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MINNESOTA DEPARTMENT OF PUBLIC SAFETY

 

Print Form

DRIVER AND VEHICLE SERVICES

 

445 Minnesota Street, Suite 187

Saint Paul, MN 55101-5187FOR OFFICE USE ONLY Phone: (651) 297-2126 TTY: (651) 282-6555

Web: dvs.dps.mn.gov

AFFIDAVIT OF REPOSSESSION / TITLE APPLICATION

Please read the instructions on the reverse side before completing this form.

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR CENTRAL OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLATE NUMBER

YEAR

 

 

MAKE

TYPE

MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF REGISTERED OWNER(S)

 

 

 

 

 

 

 

 

TITLE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

CITY

 

 

STATE

 

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I, the undersigned, on oath duly sworn, depose and say that,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF SECURED PARTY

 

DATE OF REPOSSESSION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

CITY

COUNTY CODE

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

AUTO INSURANCE COMPANY

POLICY NUMBER

 

 

 

 

EXP. DATE

 

 

 

 

 

 

 

 

 

Is the owner of the vehicle described above. The interest of the owner was lawfully terminated and disposition made pursuant to the terms of the security agreement. This application for a Certificate of Title is based on the repossession of this motor vehicle.

I further state that in consideration of the issuance of the certificate of title applied for, we hereby agree to indemnify the registrar of motor vehicles, and all persons acting for him from any and all liability which may be incurred by the issuance of such certificate and agree, at our own expense, to defend any suit which may be brought against the registrar or any person acting for him as a result of Issuing such certificate. I hereby certify I have taken all possible steps to secure the title to the above described vehicle.

ODOMETER DISCLOSURE STATEMENT

I (we) state that the odometer now reads

(no tenths) Miles

And to the best of my knowledge that it reflects the actual mileage of the vehicle described herein unless one of the following statements is checked.

I hereby certify to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits.

I hereby certify that the odometer reading is not the actual mileage.

WARNING: Odometer discrepancy if box (1) or (2) is checked.

DAMAGE DISCLOSURE STATEMENT

To the best of my knowledge this vehicle:

Has Has Not (select one)

sustained damage in excess of 80% actual cash value

I declare this tax

TITLE FEE

exemption code:

 

 

 

If needed, ID

 

number:

 

 

 

 

PSV FEE

FILING FEE

TOTAL TAX DUE

 

X

 

 

 

 

 

 

 

 

 

 

Signature of Secured Party

 

 

 

 

 

 

 

 

 

 

SUBSCRIBED AND SWORN BEFORE ME THIS

 

DAY OF

 

, 20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MY COMMISSION EXPIRES

COUNTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTARY PUBLIC SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTARY STAMP

PS2024-14 Rev. 05/18

 

 

 

-OVER-

Affidavit of Repossession/Title Application

INSTRUCTIONS

Repossession/Title Application

1.When the repossessing party chooses to title the vehicle in their name, this form also serves as their application for title.

If the repossessing party has the Minnesota title in their possession, they do not need to apply for a title in their name. If the repossessing party is a private individual, please include their driver’s license number and date of birth.

2.The following fees are due when the repossessing party titles the vehicle in their name: Title, Public Safety Vehicle (PSV), and Filing. If a private party is repossessing this vehicle, MN sales tax is due if the private party was not the previous owner. To determine the amount due, visit dvs.dps.mn.gov and select Fees from the top menu or call (651) 297-2126.

3.A secured party that has the certificate of title but elects not to title the vehicle in their name must complete and submit a dealer purchase receipt (PS2009).

4.All forms and fees may be submitted to your local deputy registrar office or by mail to:

MINNESOTA DEPARTMENT OF PUBLIC SAFETY DRIVER AND VEHICLE SERVICES

445 MINNESOTA STREET, SUITE 187

ST. PAUL, MINNESOTA 55101-5187

For a list of office locations, visit dvs.dps.mn.gov or call (651) 297-2005.

PS2024-14 Rev. 05/18

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writing affidavit of repossession form mn stage 1

Complete the STREET ADDRESS, CITY, COUNTY CODE, STATE, ZIP CODE, AUTO INSURANCE COMPANY, POLICY NUMBER, EXP DATE, Is the owner of the vehicle, I further state that in, I declare this tax exemption code, If needed ID number, ODOMETER DISCLOSURE STATEMENT I we, no tenths Miles, and And to the best of my knowledge space with all the information requested by the system.

affidavit of repossession form mn STREET ADDRESS, CITY, COUNTY CODE, STATE, ZIP CODE, AUTO INSURANCE COMPANY, POLICY NUMBER, EXP DATE, Is the owner of the vehicle, I further state that in, I declare this tax exemption code, If needed ID number, ODOMETER DISCLOSURE STATEMENT I we, no tenths Miles, and And to the best of my knowledge blanks to insert

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