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A Public Service Agency

NOTICE OF INTENT TO DISPOSE OF A VEHICLE VALUED AT $500 OR LESS REMOVED BY A PUBLIC AGENCY FOR REASONS OTHER THAN ABANDONMENT

CVC §22851.8

LIEN SALE UNIT

P. O. BOX 932317 SACRAMENTO, CA 94232-3170

This is to notify you that I intend to dispose of the vehicle to a licensed dismantler or a scrap iron processor 15 days from the date of this notice unless you take one of the following actions:

1.Pay my bill and reclaim the vehicle within 10 days from the date of this notice. However, California registered vehicles may have prior year fees and penalties due. These fees and penalties are not a part of the lien. You may wish to contact your local DMV for an estimate of the fees.

2.Stop my action to dispose of the vehicle by immediately completing the Declaration of Opposition below and returning this notice to me, the lienholder, in the enclosed envelope. Make a copy of this form for your records.

3.Disregard this notice if you no longer own or want this vehicle so I can dispose of it. You may be held liable for my cost of removal and disposition of this vehicle if you are the last owner of record and have failed to complete and ﬁle a Notice of Transfer and Release of Liability (REG 138) with DMV prior to receipt of this notice.

LICENSE NUMBER

STATE REGISTERED

LICENSE EXPIRATION DATE

VEHICLE IDENTIFICATION NUMBER

NAME AND ADDRESS OF REGISTERED OWNER(S)

VEHICLE
DESCRIPTION	MAKE	YEAR MODEL		BODY TYPE	ENGINE NUMBER (MOTORCYCLES ONLY)

	DATE VEHICLE CAME INTO MY POSSESSION			DATE NOTICE MAILED		DATE OF INTENDED DISPOSAL			NAME AND ADDRESS OF LEGAL OWNER(S)
INFORMATION
ABOUT THE	NOTE: Storage fees may continue to accrue at the rate designated.
SALE	As of this date,			, the amount and basis for my lien and outstanding parking violation bail is:

	STORAGE TO DATE	AT RATE OF		TOWING	PARKING VIOLATION CVC #22851.1	COST TO PROCESS DISPOSAL ($70 MAXIMUM)
	$	$	per day	$	$	$
	LIENHOLDER NAME					DAYTIME TELEPHONE NUMBER			NAME AND ADDRESS OF INTERESTED PARTIES
						(	)

	TRUE FULL NAME

	STREET ADDRESS				CITY	STATE		ZIP CODE

CERTIFICATION	AGENT ACTING FOR LIENHOLDER (NAME)				REGISTRATION SERVICE NUMBER	DAYTIME TELEPHONE NUMBER
CERTIFICATION						(	)
						(	)

	STREET ADDRESS				CITY	STATE		ZIP CODE

	I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I further
	certify that I have no information or belief that there is a valid defense to the claim which gives rise to the lien.

	DATE			SIGNATURE OF LIENHOLDER OR AGENT ACTING AS LIENHOLDER
				X

	Do not dispose of the above described vehicle because I wish to contest the claim. I understand you may file an action in court and if a judgment is given Note to the Lienholder:
	in your favor, I may be liable for court costs. The address where I may be served or notified in person of any court action is:								This notice is to be sent to the registered owner, legal
	TRUE FULL NAME (PRINT)					DAYTIME TELEPHONE NUMBER			owner, and any other person known to have an interest
						(	)		in this vehicle.

DECLARATION	STREET ADDRESS				CITY	STATE		ZIP CODE	Send by certified mail, return receipt requested, or
DECLARATION									Send by certified mail, return receipt requested, or
OF									U.S. Postal Service Certificate of Mailing, at least 15
OPPOSITION									working days prior to the intended disposal date.
OPPOSITION	MAILING ADDRESS (IF DIFFERENT FROM ABOVE)								working days prior to the intended disposal date.

	I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
	DATE			SIGNATURE OF DECLARANT
				X

	IF YOU WISH TO STOP THE SALE OF THIS VEHICLE, COMPLETE AND RETURN THIS FORM IN THE ENCLOSED ENVELOPE WITHIN 10 DAYS FROM
	THE DATE OF THIS NOTICE. This Declaration of Opposition will not be valid unless you have signed, given your true full name and a valid address. If the
	lienholder is unable to serve you with a court action, the lienholder will be allowed to continue with the disposal of the vehicle.

REG 684 (REV. 4/2008) WWW

(Side A)

	NOTICE OF INTENT TO DISPOSE OF A VEHICLE VALUED AT $500 OR LESS	LIEN SALE UNIT
	REMOVED BY A PUBLIC AGENCY	P. O. BOX 932317
	REMOVED BY A PUBLIC AGENCY	SACRAMENTO, CA 94232-3170
A Public Service Agency	CVC §22669	SACRAMENTO, CA 94232-3170
A Public Service Agency

This is to notify you that the vehicle described below was removed, pursuant to California Vehicle Code (CVC) §22669, from a public street at the order of the public agency identiﬁed below. I intend to dispose of the vehicle to a licensed dismantler or a scrap iron processor 15 days from the date of this notice unless you take one of the following actions:

2.Stop my action to dispose of the vehicle by immediately requesting a hearing before the public agency that removed or caused the removal of the vehicle. The request may be made in person, in writing or by telephone within 10 days from the date of this notice. (If you request a hearing and you disagree with the decision of the public agency, the decision may be reviewed pursuant to Government Code §11523. The vehicle cannot be disposed of during this time.)

	PUBLIC AGENCY NAME							NAME AND ADDRESS OF REGISTERED OWNER(S)
PUBLIC
PUBLIC	STREET ADDRESS
AGENCY

	CITY			STATE	ZIP CODE	DAYTIME TELEPHONE NUMBER
						(	)

	LICENSE NUMBER	STATE REGISTERED		LICENSE EXPIRATION DATE	VEHICLE IDENTIFICATION NUMBER			NAME AND ADDRESS OF LEGAL OWNER(S)
VEHICLE
DESCRIPTION	MAKE	YEAR MODEL		BODY TYPE	ENGINE NUMBER (MOTORCYCLES ONLY)

	DATE VEHICLE CAME INTO MY POSSESSION			DATE NOTICE MAILED		DATE OF INTENDED DISPOSAL		NAME AND ADDRESS OF INTERESTED PARTIES
INFORMATION
INFORMATION	NOTE: Storage fees may continue to accrue at the rate designated.
ABOUT THE
ABOUT THE	As of this date,			, the amount and basis for my lien and outstanding parking violation bail is:
LIEN	As of this date,
LIEN
	STORAGE TO DATE	AT RATE OF		TOWING	PARKING VIOLATION CVC #22851.1	COST TO PROCESS DISPOSAL ($70 MAXIMUM)
	$	$	per day	$	$	$

	LIENHOLDER (NAME)
WHERE
WHERE	STREET ADDRESS
VEHICLE IS	STREET ADDRESS
VEHICLE IS
STORED
	CITY			STATE	ZIP CODE	DAYTIME TELEPHONE NUMBER
						(	)

	LIENHOLDER (NAME)					DAYTIME TELEPHONE NUMBER		Note to the Lienholder:
						(	)	Note to the Lienholder:
						(	)	This notice is to be sent to the registered owner, legal
	TRUE FULL NAME (PRINT)							owner, and any other person known to have an interest
								in this vehicle.

	STREET ADDRESS				CITY	STATE	ZIP CODE	Send by certiﬁed mail, return receipt requested, or
								Send by certiﬁed mail, return receipt requested, or
								U.S. Postal Service Certiﬁcate of Mailing at least 15
CERTIFICATION	AGENT ACTING FOR LIENHOLDER (NAME)				REGISTRATION SERVICE NUMBER	DAYTIME TELEPHONE NUMBER		working days prior to the intended disposal date.
CERTIFICATION						(	)
						(	)
	STREET ADDRESS				CITY	STATE	ZIP CODE

	I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I further
	certify that I have no information or belief that there is a valid defense to the claim which gives rise to the lien.

	DATE			SIGNATURE OF LIENHOLDER OR AGENT ACTING AS LIENHOLDER
				X

(Side B)	REG 684 (REV. 4/2008) WWW

Question	Answer
Form Name	Dmv Reg 684 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	lienholder, notice of intention to dispose of motor vehicle, CVC, notice of intent to sell dmv

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