Form 4054 PDF Details

The purposes for which the attorney-in-fact can act on behalf of the vehicle owner include: trasferring ownership and making title and registration application for the described unit.

The form requires the vehicle owner(s) to appoint an individual as their attorney-in-fact, providing the full authority to sign on the owner's behalf for all papers and documents necessary for the appointment. If the power of attorney is being assigned to an insurance company due to a total loss, the insurance company name and date of total loss must be provided.

The form also contains a section for notary information and the owner's signature. However, notarization is not required if the owner is signing electronically, which is permissible only when assigning power of attorney to an insurance company due to a total loss.

QuestionAnswer
Form NameMissouri Form 4054
Form Length1 pages
Fillable?Yes
Fillable fields21
Avg. time to fill out4 min 31 sec
Other namesmissouri form 4054, SUBSCRIBED, EXPIRES, EMBOSSER

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Form

 

4054

Power of Attorney

 

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I (we) hereby appoint, __________________________________________________ as my (our) attorney-in-fact for the

(If insurance company involving total loss, complete boxes immediately below.)

Insurance Company Name

purpose of:

Date of Total Loss

__ __ /__ __ /__ __ __ __

rTransferring ownership for the following described unit:

rMaking application for title for the following described unit:

rMaking application for registration for the following described unit:

Year (YYYY)

Make

Identification Number

with the full authority to sign on my (our) behalf all papers and documents and to do all that is necessary to this appointment.

Signature

Owner’s Printed Name

Owner’s Signature*

Owner’s Printed Name

Owner’s Signature*

Owner’s Printed Name

Owner’s Signature*

Date (MM/DD/YYYY)

__ __ /__ __ /__ __ __ __

Date (MM/DD/YYYY)

__ __ /__ __ /__ __ __ __

Date (MM/DD/YYYY)

__ __ /__ __ /__ __ __ __

Notary Information

Note: License Office notary service - $2.00

Embosser or black ink rubber stamp seal*

Subscribed and sworn before me, this

 

 

 

day of

year

 

State

County (or City of St. Louis)

My Commission Expires (MM/DD/YYYY)

 

 

 

__ __ /__ __ /__ __ __ __

 

Notary Public Signature

 

 

 

 

 

 

Notary Public Name (Typed or Printed)

 

 

 

 

 

*Owner(s) electronic signature is permissible ONLY when assigning power of attorney to an insurance company due to total loss. Notarization is not required if signing electronically.

Form 4054 (Revised 08-2019)

Motor Vehicle Bureau

Phone: (573) 526-3669

Visit http://dor.mo.gov/motorv/

 

 

for additional information.

How to Edit Missouri Form 4054 Online for Free

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EXPIRES blanks to fill in

Include the required details in the Owners Printed Name, Owners Signature, Owners Printed Name, Owners Signature, Owners Printed Name, Owners Signature, Date MMDDYYYY, Date MMDDYYYY, Date MMDDYYYY, Note License Office notary service, Embosser or black ink rubber stamp, Subscribed and sworn before me this, State, County or City of St Louis, and My Commission Expires MMDDYYYY box.

part 2 to completing EXPIRES

You can be required some key details so you can submit the Notary Public Name Typed or Printed, y r a t o N, Owners electronic signature is, Motor Vehicle Bureau, Phone, Visit httpdormogovmotorv for, and Form Revised field.

EXPIRES Notary Public Name Typed or Printed, y r a t o N, Owners electronic signature is, Motor Vehicle Bureau, Phone, Visit httpdormogovmotorv for, and Form Revised blanks to fill

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