Dmv Vsa 41 Form PDF Details

If you're looking to apply for a driver's license in the state of Virginia, you'll need to know about the DMV VSA 41 form. This is the form that you need to fill out in order to apply for your license, and it's important that you complete it correctly. In this post, we'll go over what information you need to provide on the form and how to submit it. We'll also tell you what steps you need to take after submitting your application.

This knowledge will aid you to understand better the details of the dmv vsa 41 form before starting filling it out.

QuestionAnswer
Form NameDmv Vsa 41 Form
Form Length4 pages
Fillable?Yes
Fillable fields105
Avg. time to fill out22 min 4 sec
Other namesvsa 41 forms, virginia storage lien, va storage lien, virginia dmv storage

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MECHANICS OR STORAGE LIEN

APPLICATION

VSA 41 (07/01/2015)

PURPOSE: Use this application to request vehicle information and to apply for a title or non-repairable certificate as a result of a

mechanic's or storage lien, as provided in Va Code §§46.2-644.01, 46.2-644.02 and 46.2-644.03.

INSTRUCTIONS: Complete this application using the instructions provided on page 2 of this form. The vehicle and company must be located in Virginia and the lien request must be for action that took place in Virginia.

VEHICLE LIEN INFORMATION

Liens apply only to vehicles. Check applicable box: (both may apply)

 

 

 

I have a Storage Lien under Va Code § 46.2-644.01 in the amount of

$

 

 

 

 

 

 

 

 

I have a Mechanic's Lien under Va Code § 46.2-644.02 in the amount of

$

 

 

Total

$

 

 

 

 

 

 

 

Was this vehicle towed at the direction of law enforcement?

YES

 

NO

 

 

 

If yes, enter date towed (mm/dd/yyyy):

MECHANIC OR STORAGE LIENHOLDER INFORMATION

NAME OF COMPANY HOLDING VEHICLE

COMPANY TELEPHONE NUMBER

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

CITY

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

FEIN OR SOCIAL SECURITY NUMBER

(Required by the State Comptroller for

USE AGREEMENT NUMBER (if applicable)

ACCESS CODE (if applicable)

 

 

debt off-set purposes per Va Code

 

 

 

 

 

 

 

§§2.2-803, 2.2-4807, et.al)

 

 

 

 

 

 

STREET ADDRESS WHERE VEHICLE IS HELD (if different from above)

CITY

STATE

ZIP CODE

TELEPHONE NUMBER

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLE SERVICE INFORMATION

 

 

 

 

 

 

(Complete this section only if a titling service is submitting this request on behalf of the lienholder.)

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLING SERVICE NAME

 

 

 

TELEPHONE NUMBER

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

CITY

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

FEIN OR SOCIAL SECURITY NUMBER

(Required by the State Comptroller for

USE AGREEMENT NUMBER (if applicable)

ACCESS CODE (if applicable)

 

 

debt off-set purposes per Va Code

 

 

 

 

 

 

 

§§2.2-803, 2.2-4807, et.al)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MAKE

MODEL

BODY TYPE

COLOR

LICENSE PLATE NUMBER

STATE

VEHICLE IDENTIFICATION NUMBER

VALUE (check one) $3000 or less

$3001 to $12,500 $12,501 to $25,000 $25,001 or more

DMV verifies a vehicle's value using the NADA trade in value. If there is good reason to believe that the vehicle should be valued at $12,500 or less but the NADA trade in value is more than $12,500, you may present other creditable evidence to support lowering the vehicle value. An example would be an independent appraisal. This evidence will be reviewed by DMV to determine an appropriate value.

INFORMATION REQUEST

This is to request that DMV furnish information from its files on the above-described vehicle in accordance with Va. Code §§46.2-644.01, 46.2-644.02 and 46.2-644.03. I understand that it is unlawful to use information provided by DMV for any purpose other than the one stated. I certify that the information I have requested with this form will be used only for the stated purpose.

I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and correct. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

AUTHORIZED MECHANIC OR STORAGE LIENHOLDER NAME (print)

SIGNATURE

DATE(mm/dd/yyyy)

 

 

 

AUTHORIZED TITLE SERVICE REPRESENTATIVE NAME (print)

SIGNATURE

DATE(mm/dd/yyyy)

 

 

 

DMV USE ONLY

DMV recognized the NADA Official Used Car Guide trade in value: $_____________

NCIC Checked: is vehicle reported stolen?

 

YES

 

NO

 

 

 

 

 

NADA Trade in Value: (Check applicable box.)

$3,000 or less and $3,001 to $12,500 (DMV may process title application)

 

 

 

$12,501 to $25,000 (Must petition General District Court)

 

 

 

$25,001 or more (Must petition the Circuit Court)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CSR STAMP

CSR STAMP

CSR STAMP

WORK CENTER CLERK

 

VSA WORK CENTER

 

NLETS STAMP

 

 

 

 

 

 

 

 

STAMP

 

STAMP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VSA 41 (07/01/2015)

Page 2

DEFINITIONS

For the purposes of a mechanic's or storage lien, the following definitions apply:

Trade in Value -- the vehicle value as determined by the NADA OFFICIAL USED CAR GUIDE.

Notice of Intent to Sell Virginia record found --The mechanic or lienholder must arrange for the vehicle to be sold at a public auction, and at least 10 days prior to the public auction:

notify the owner and lienholder, if any, by certified mail return receipt, of the date,time and place of the auction, and

advertise the date, time, place and terms of the auction in at least one public place (see definition below).

Note: If the MSL Transcript indicates that the vehicle owner is on active military duty or service, you must obtain a court order granting the enforcement of the lien as required under the Servicemembers Civil Relief Act, 50 U.S.C. App §535. DMV will begin collecting this information, effective July 1, 2008, on all title and registration applications; therefore the active military duty status will not be available for all customers. As a result, the MSL applicant will be responsible for obtaining the active military duty status from other sources.

Notice of Intent to Sell, No Virginia or non-Virginia record found or the owner's address is unknown -- The mechanic or storage lienholder must arrange for the vehicle to be sold at public auction, and at least 10 days prior to the public auction, advertise the date, time, place and terms of the auction in three different public places (see definition below).

Public Place -- premises owned by the Commonwealth of Virginia or a political subdivision thereof, or an agency of either which is open to the public and permits such postings.

Independent Appraiser - Someone who provides the MSL applicant with an estimated trade-in value appraisal and does not gain income or have personal or business related interest in the ownership or sale of the vehicle.

INSTRUCTIONS

To obtain a Virginia title or Non-Repairable Certificate for the vehicle, follow these instructions according to the vehicle's value.

Vehicle Value:

Instructions:

 

 

$3,000 or Less

The mechanic or storage lienholder may apply for a title or non-repairable certificate for a motor vehicle, free of

 

all liens and claims of ownership of others, and may sell or otherwise dispose of the vehicle, provided all four of

 

the following conditions are present:

 

• No owner or any other lienholder or secured party was determined by the Department of Motor Vehicles

 

(DMV).

 

• The vehicle was manufactured at least six years prior to the current model year.

 

• The vehicle has a value of $3,000 or less.

 

• The vehicle has been in the continuous custody of the mechanic or storage lienholder for at least 30 days.

 

The mechanic's or vehicle storage lien applicant may present to DMV an Application for Certificate of Title and

 

Registration (VSA 17A) with applicable fees or an Application for Non-Repairable Certificate (VSA 57) and this

 

form.

$3,001 to $12,500 The mechanic or storage lienholder must:

Request DMV to search title records available for the vehicle owner and lienholder, if any; and

Make notice of the intent to sell the vehicle (as described above).

The purchaser (after the auction) must present to DMV all of the following:

The results of DMV's record search and a completed Mechanic's or Storage Lien Application (VSA 41, pages 1 & 3);

A completed Application for Certificate of Title and Registration (VSA 17A) with applicable fees or a completed Application for Non-Repairable Certificate (VSA 57);

A bill of sale from the mechanic or storage lienholder holding the auction;

A copy of the public auction notice and location of posting;

A copy of the original repair order; and

The return receipt for the certified mail, if delivered, or the certified letter (unopened) with the return receipt attached, if not delivered. The return receipt can be an electronic copy from the U.S. Postal Service.

$12,501 to $25,000 The mechanic or storage lienholder must:

Request DMV to search title records available for the vehicle owner and lienholder, if any; and

Petition the General District Court, in the city or county where the vehicle is located, to order the sale of the vehicle.

 

The purchaser must present to DMV all of the following:

 

• The results of DMV's record search and a completed Mechanic's or Storage Lien Application (VSA 41,

 

pages 1 & 3)

 

• A completed Application for Certificate of Title and Registration (VSA 17A), with applicable fees or a

 

completed Application for Non-Repairable Certificate (VSA 57); and

 

• An affidavit (VSA 41, page 3) from the sheriff stating that the vehicle was sold in compliance with the court's

 

order.

 

 

$25,001 or More

The mechanic or storage lienholder must:

 

• Request DMV to search title records available for the vehicle owner and lienholder if any; and

 

• Petition the Circuit Court, in the city or county where the vehicle is located, to order the sale of the vehicle.

The purchaser must present to DMV all of the following:

The results of DMV's record search and a completed Mechanic's or Storage Lien Application (VSA 41, pages 1 & 3);

Completed Application for Certificate of Title and Registration (VSA 17A), with applicable fees or a completed Application for Non-Repairable Certificate (VSA 57); and

An affidavit (VSA 41, page 3) from the sheriff stating that the vehicle was sold in compliance with the court's order.

MECHANICS OR STORAGE LIEN

APPLICATION

AFFIDAVIT OF COMPLIANCE WITH VA CODE §§ 46.2-644.01 THROUGH 46.2-644.03

VSA 41 (07/01/2015) Page 3

PURPOSE: This affidavit must be completed by the mechanic or storage lienholder and must be submitted by the purchaser with the required documents, fees and taxes.

INSTRUCTIONS: Print or type. Follow the instructions on page 2.

PURCHASER INFORMATION

PURCHASER'S NAME

VEHICLE SALE DATE (mm/dd/yyyy)

VEHICLE SALE PRICE

$

VEHICLE YEAR

VEHICLE MAKE

VEHICLE IDENTIFICATION NUMBER (VIN)

VEHICLE QUALIFICATION

Check this box if the vehicle was stored and qualified as abandoned under Va Code §§ 46.2-1209, 46.2- 1213 or 46.2-1215 and at least 30 days have passed since the vehicle was towed at the direction of law enforcement.

DATE VEHICLE WAS TOWED (Should be same date as on page 1)

Check this box if the vehicle qualifies to be titled or issued a non-repairable certificate under Va Code §46.2-644.03 when the value is $3,000 OR LESS.

NOTE: The mechanic or storage lienholder may apply to DMV for a Title or a Non-Repairable Certificate for a motor vehicle, free of all liens and claims of ownership of others, and may sell or otherwise dispose of the vehicle if all four of the following conditions are present:

No owner or any other lienholder or secured party of the vehicle was determined by the Virginia DMV.

The vehicle was manufactured at least six years prior to the current model year.

The vehicle has a value of $3,000 or less.

The vehicle has been in the continuous custody of the mechanic or storage lienholder for at least 30 days.

COMPLIANCE INFORMATION

As the Mechanic or Storage Lienholder, I have: (Check all applicable boxes)

applied to DMV for vehicle owner and lienholder information as a result of a Mechanic's or Storage Lien that occurred in Virginia.

made reasonable attempts to contact the lienholder(s), if any, by telephone on date(s) of

made notice of intent to sell the vehicle under the procedure prescribed by Va Code §§ 46.2-644.01 through 46.2-644.03.

arranged for the vehicle to be sold under the procedure prescribed by Va Code §§ 46.2-644.01 through 46.2-644.03.

CERTIFICATION / AFFIDAVIT

(Must be signed and dated by the mechanic or storage lienholder in the presence of a notary public.)

I certify that I have complied with the requirements of Va Code § 46.2-644.03.

I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and correct. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

MECHANIC OR STORAGE LIENHOLDER NAME (PRINT)

MECHANIC OR STORAGE LIENHOLDER SIGNATURE

DATE (mm/dd/yyyy)

NOTARIZATION (must be completed by notary public)

Commonwealth of Virginia, city or county of _____________________________________ subscribed and

sworn before me on this _________________ day of __________________________________________

(MONTH)(YEAR)

by___________________________________________________ in the city or county and state aforesaid.

NOTARY PUBLIC SEAL

REGISTRATION NUMBER (6 digits)

MY COMMISSION EXPIRES (mm/dd/yyyy)

NOTARY PUBLIC NAME

NOTARY PUBLIC SIGNATURE

SHERIFF'S AFFIDAVIT

The vehicle was sold in compliance with a court order.

SHERIFF NAME (PRINT)

SHERIFF SIGNATURE

SHERIFF JURISDICTION

DATE (mm/dd/yyyy)

MECHANICS OR STORAGE LIEN

APPLICATION

This Page For DMV Use Only

VSA 41 (07/01/2015) Page 4

PURPOSE: Only a DMV Special Agent may complete this section, if requested to inspect a vehicle.

INSTRUCTIONS: The customer service center completes the checklist of documents to be presented to DMV before a title is issued.

FOR DMV USE ONLY

All applicants must present a completed VSA 17A or VSA 57, VSA 41, the DMV Record Search Results and all required documentation according to the vehicle's value.

Check documents presented:

Completed VSA 17A

Completed VSA 57

Completed VSA 41

DMV Record Search Results

The following documents are listed according to the vehicle's loan value.

VEHICLE VALUE:

 

 

 

DOCUMENTATION REQUIRED:

 

 

 

 

 

 

Documents presented to

 

 

The mechanic or storage lienholder may apply for a title or non-repairable certificate to a vehicle, free of all liens

 

DMV for trade in value of

 

 

and claims of ownership of others, and may sell or otherwise dispose of the vehicle provided all four of the

 

$3,000 or Less

 

 

 

following conditions are present:

 

 

 

 

 

 

 

 

 

 

 

 

No owner or any other lienholder or secured party was determined by the Virginia DMV.

 

 

 

 

 

 

 

The vehicle was manufactured at least six years prior to the current model year.

 

 

 

 

 

 

 

The vehicle has a trade in value of $3,000 or less.

 

 

 

 

 

 

 

 

 

 

 

The vehicle has been in the continuous custody of the mechanic or storage lienholder for at least 30 days.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documents presented to

 

 

 

Bill of Sale from lienholder

 

Certified mail return receipt (signed) or electronic

 

DMV for trade in value of

 

 

 

Copy of public auction notice

 

copy from U.S. Postal Service

 

$3,001 to 12,500

 

 

 

 

Undelivered certified mail (unopened)

 

 

 

 

Copy of original repair order

 

 

 

 

 

 

 

 

 

List of place(s) notice(s) was/were posted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documents presented to

 

 

 

 

 

 

 

 

 

TELLER STAMP

 

 

 

 

Sale documentation from sheriff

 

 

 

 

 

 

DMV for trade in value of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$12,501 to $25,000

 

 

Sheriff must complete the VSA 41 affidavit (page 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documents presented to

 

 

 

Sale documentation from sheriff

 

 

 

 

 

 

DMV for trade in value of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$25,001 or more

 

 

Sheriff must complete the VSA 41 affidavit (page 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CSR REMARKS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOCUMENTS WITNESSED BY NAME (print)

 

 

 

 

WITNESS SIGNATURE

 

 

 

DATE (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER (VIN)

 

 

 

 

 

 

 

ODOMETER READING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR (yyyy)

 

MAKE

 

 

 

 

 

MODEL

BODY TYPE

 

 

COLOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VIN IS: (Check all applicable boxes)

 

 

 

 

 

 

 

LICENSE PLATE NUMBER

 

STATE

 

Correct

Missing

Changed

 

 

Altered or tampered with

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inspection indicates that cost to repair vehicle:

 

 

 

SPECIAL AGENT REMARKS

 

 

 

 

 

 

Appears to be non-repairable

 

 

 

 

 

 

 

 

 

 

 

 

 

Appears to be $3,000 or less

 

 

 

 

 

 

 

 

 

 

 

 

 

Appears to be $3,001 to $12,500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPECIAL AGENT DECISION (decision of the special agent is final)

 

SPECIAL AGENT SEAL

 

Appears to be $12,501 to $25,000

 

 

 

 

 

 

 

 

 

 

 

 

Process may be handled by DMV.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appears to be $25,001 or more

 

 

 

Process must be handled by the court.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPECIAL AGENT NAME (print)

CODE NUMBER

SPECIAL AGENT SIGNATURE

INSPECTION DATE

How to Edit Dmv Vsa 41 Form Online for Free

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virginia dmv storage lien empty fields to consider

Jot down the information in the This is to request that DMV, AUTHORIZED MECHANIC OR STORAGE, SIGNATURE, AUTHORIZED TITLE SERVICE, SIGNATURE, DATE(mm/dd/yyyy), DATE(mm/dd/yyyy), DMV recognized the NADA Official, NCIC Checked: is vehicle reported, YES, NADA Trade in Value: (Check, $12, $25, CSR STAMP, and CSR STAMP field.

stage 2 to entering details in virginia dmv storage lien

In the segment discussing PURCHASER'S NAME, VEHICLE SALE PRICE $, PURCHASER INFORMATION, VEHICLE SALE DATE (mm/dd/yyyy), VEHICLE YEAR, VEHICLE MAKE, VEHICLE IDENTIFICATION NUMBER (VIN), Check this box if the vehicle was, DATE VEHICLE WAS TOWED (Should be, VEHICLE QUALIFICATION, Check this box if the vehicle, NOTE: The mechanic or storage, • No owner or any other lienholder, COMPLIANCE INFORMATION, and As the Mechanic or Storage, you have to put in writing some essential data.

virginia dmv storage lien PURCHASER

The MECHANIC OR STORAGE LIENHOLDER, MECHANIC OR STORAGE LIENHOLDER, DATE (mm/dd/yyyy), Commonwealth of Virginia, NOTARY PUBLIC SEAL, NOTARIZATION (must be completed by, sworn before me on this day of , (MONTH) (YEAR), by in the city or county and state, REGISTRATION NUMBER (6 digits), MY COMMISSION EXPIRES (mm/dd/yyyy), NOTARY PUBLIC NAME, NOTARY PUBLIC SIGNATURE, The vehicle was sold in compliance, and SHERIFF'S AFFIDAVIT field is going to be place to include the rights and responsibilities of all sides.

Filling in virginia dmv storage lien part 4

End by checking the following sections and filling them out accordingly: CSR REMARKS:, Sheriff must complete the VSA 41, DOCUMENTS WITNESSED BY NAME (print), WITNESS SIGNATURE, DATE (mm/dd/yyyy), VEHICLE IDENTIFICATION NUMBER (VIN), ODOMETER READING, YEAR (yyyy), MAKE, MODEL, BODY TYPE, COLOR, VIN IS: (Check all applicable, LICENSE PLATE NUMBER, and STATE.

virginia dmv storage lien CSR REMARKS:, Sheriff must complete the VSA 41, DOCUMENTS WITNESSED BY NAME (print), WITNESS SIGNATURE, DATE (mm/dd/yyyy), VEHICLE IDENTIFICATION NUMBER (VIN), ODOMETER READING, YEAR (yyyy), MAKE, MODEL, BODY TYPE, COLOR, VIN IS: (Check all applicable, LICENSE PLATE NUMBER, and STATE blanks to fill out

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