Form 411007 PDF Details

The 411007 form is a comprehensive document designed for individuals and entities in Iowa to apply for a Certificate of Title and/or Registration for their vehicles. This form caters to a broad spectrum of applicants, including private owners, dealers, recyclers, and organizations, enabling them to formalize their vehicle's status. Required fields include detailed owner information, such as names, identification numbers, and addresses, which ensures that the title or registration is correctly aligned with the legal owner. In addition to owner details, the form collects intricate data about the vehicle itself, including the Vehicle Identification Number (VIN), make, model, and other specifics, making it easier for the state to track and manage vehicle registrations. The form also delves into security interest information, capturing details about liens against the vehicle to protect financial interests. An interesting aspect of the 411007 form is its inclusion of a section for applying for exemptions from new registration fees, with a variety of scenarios covered, from gifts to vehicles used solely in interstate commerce. Clearly, this document is crucial for ensuring that all vehicles in Iowa are properly documented and meet the state's regulatory requirements, while also providing options for various exemptions and special conditions.

QuestionAnswer
Form NameForm 411007
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesiowa 411007 application, 411007, iowa dot form 411007, iowa dot form 41107

Form Preview Example

APPLICATION FOR CERTIFICATE OF TITLE AND/OR REGISTRATION

D# or R#:

Form 411007 (12-12)

Applying For:

Regular Title

Salvage Title

Registration Month:

 

OWNER INFORMATION

 

(Dealer or Recycler Number)

Present to: The County Treasurer of your residence; The County Treasurer of the primary user if non-resident owned;

The County Treasurer of residence or of the primary user if owned by a firm, association, or corporation.

Owner #1:

 

 

 

Iowa DL No. or Iowa ID No. or Social Security No.:

 

First Name

Middle Name

Last Name

(If individual)

 

Ownership Status:

(Check One)

OR

AND

Birth Date:

Federal Employer Identification No.:

 

 

(If individual)

(If organization)

Bona fide Residence Address of Owner #1:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

County

State

ZIP Code

Mailing Address of Owner #1:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

City

 

County

 

 

State

 

ZIP Code

Owner #2:

 

 

 

Iowa DL No. or Iowa ID No. or Social Security No.:

 

 

First Name

Middle Name

Last Name

(If individual)

 

 

 

 

 

 

 

 

 

 

 

Birth Date:

 

Federal Employer Identification No.:

 

 

 

 

(Check One)

 

 

(If individual)

(If organization)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bona fide Residence Address of Owner #2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

County

 

State

ZIP Code

Mailing Address of Owner #2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

City

 

County

 

 

State

 

ZIP Code

Owner #3:

 

 

 

Iowa DL No. or Iowa ID No. or Social Security No.:

 

 

First Name

Middle Name

Last Name

(If individual)

 

 

 

 

 

 

 

 

 

 

Birth Date:

 

Federal Employer Identification No.:

 

 

 

 

 

(Check One)

 

 

(If individual)

(If organization)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bona fide Residence Address of Owner #3:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

City

 

County

State

ZIP Code

 

Mailing Address of Owner #3:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

City

 

 

County

 

State

 

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VIN:

 

Year:

 

Make:

 

 

 

 

Model:

 

 

 

Type (car, truck, etc.):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Style:

 

Color:

 

 

 

Fuel:

 

 

 

Cylinders:

 

 

 

Tonnage:

 

GVWR:

 

Sq. Footage:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Iowa Plate No. (If applicable):

 

 

Validation No.:

 

 

 

 

Validation Year:

 

 

 

 

 

Purchase Date or Date Brought Into State:

 

 

 

VIN of traded vehicle (If applicable):

 

 

 

 

 

 

 

 

 

Trailer Empty Weight (If applicable):

Over 2,000lbs.

2,000lbs. or less

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECURITY INTEREST INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Give complete statement of security interests (liens). If none, so state:

Nature

Held By

Address (Street, City, State, ZIP Code)

 

 

 

First

 

 

Security

 

 

 

 

Interest:

 

Federal Employer Identification #, Social Security #, or ELT Identifier:

 

 

 

Second

 

 

Security

 

 

 

 

Interest:

 

Federal Employer Identification #, Social Security #, or ELT Identifier:

 

 

 

Third

 

 

Security

 

 

 

 

Interest:

 

Federal Employer Identification #, Social Security #, or ELT Identifier:

 

 

 

 

 

 

 

 

PURCHASE PRICE

 

 

 

Purchase Price (Purchase price less any trade): $ (Check only if applicable)

I claim exemption from payment of the fee for new registration.List Exemption Code:

 

 

I claim a business trade exemption for my truck..

(See Page 2)

 

 

 

 

 

 

 

 

 

I/We cerify under penalty of perjury that the foregoing is true and correct*

 

 

 

x

 

 

 

 

Signature of Owner No. 1

 

Date

x

 

 

Signature of Owner No. 2

 

Date

x

 

 

 

 

 

Signature of Owner No. 3

 

Date

By

 

 

 

 

 

If Firm, Association, Corporation, or Attorney in Fact

 

 

THE FOLLOWING FOR DEALER USE ONLY The vehicle dealer named below as "seller" does hereby certify that the new vehicle described above was sold to the applicant for the following consideration which includes freight, manufacturer's tax, accessories, and other added equipment or services and represented to total delivered price to the purchaser, valued in money whether received money or otherwise.

 

 

 

Date Registration Applied For

Sale Price

$

 

Card Issued:

 

Less Trade-in

$

 

If none, so state:

 

Less charges exempt from fee for new registration

$

 

Registration Fee Collected:$

...Less Rebate applied to purchase price of the vehicle

$

 

 

 

 

 

Equals Fee For New Registration Price

$

 

 

 

 

 

I/We certify under penalty of perjury that the foregoing is true and correct.

 

 

 

 

 

Date

Dealer No.

 

Dealership Name

 

 

 

 

 

Authorized Representative & Title

*Important: Be certain that dates and other information given are correct. Any person who uses a false or fictitious name, makes a false statement, or otherwise commits a fraud upon this application is punishable by prison sentence and possible fine. This application also constitutes an application for refund of excess credit, when applicable.

Yes, I would like to make a voluntary contribution to the anatomical gift public awareness and transplantation fund in the amount of: $

Page 1 of 2

APPLICATION FOR CERTIFICATE OF TITLE AND/OR REGISTRATION

Form 411007 (12-12)

PRIMARY USER INFORMATION (Complete only if the vehicle is owned by a non-resident or by a firm, association, or corporation)

Primary User #1:

 

 

 

Iowa DL No. or Iowa ID No. or Social Security No.:

 

 

 

 

 

 

First Name

Middle Name

Last Name

(If individual)

 

 

Birth Date:

 

Federal Employer Identification No.:

 

 

 

 

 

 

(Check One)

 

(If individual)

(If organization)

 

 

Bona fide Residence Address of Primary User #1:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

County

 

State

ZIP Code

Mailing Address of Primary User #1:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

City

 

County

 

State

 

ZIP Code

Primary User #2:

 

 

 

 

 

Iowa DL No. or Iowa ID No. or Social Security No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

Middle Name

Last Name

(If individual)

 

 

 

 

 

 

 

 

 

 

Birth Date:

 

Federal Employer Identification No.:

 

 

 

 

(Check One)

 

 

 

(If individual)

(If organization)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bona fide Residence Address of Primary User #2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

City

 

 

County

State

ZIP Code

Mailing Address of Primary User #2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

 

 

County

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FEE FOR NEW REGISTRATION - EXEMPTIONS

 

 

 

 

 

 

 

 

 

Owner Name:

 

 

 

VIN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If claiming an exemption from payment of the fee for new registration, check the appropriate box below and complete any required additional information. Any applicable exemption code must be listed above the signature line of this title application form.

UT01 - Transfer by gift, please explain:

UT02 - Purchase is one of the following non-profit or government organizations:

a. Rehabilitation Facility.

 

b. Rehabilitation Facility for Mentally Challanged Children

c. Care Facility (residential/intermediate for the Mentally Challenged)

 

d. Care Facility (residential) for the Mentally ill

 

e. Educational Institution (Private, non-profit)

 

f. Free-standing Hospice Facility

 

g. Government

 

h. Hospital licensed under Iowa Code Chapter 135B

 

i. Community Health Center

 

j. Migrant Health Center

 

k. Community Mental Health Center

 

l. Legal Aid Organization

 

m. Non-Profit Private Museum

 

n. Non-Profit Art Center

 

o. Non-Profit Organ Procurement Organization

 

 

UT03 -

a. Vehicle transferred from a sole proprietorship or partnership to a corporation or LLC (or vice versa) with the ownership remaining exactly the same and for the purpose of continuing the same business.

b. Corporate Merger - vehicle transferred pursuant to statute to the surviving corporation for no consideration, the merging corporation being dissolved the moment the merger occurs and receiving no benefit from the merger.

Termination date of prior business:

 

Date of creation of new entity:

UT04 - Purchased by a licensed dealership for resale. Dealer License No.:

UT05 - Purchased for rental. Purchaser's sales tax permit no.:

UT06 - Leased vehicle used solely in interstate commerce.

UT07 - Vehicle registered and/or operated under Iowa Code Section 326 (reciprocity) with gross weight of 13 tons or more and with 25% of the mileage outside of Iowa. Both weight and mileage must be met for the first four years of operation to be eligible for the exemption.

UT08 - Other:

 

 

 

 

a. Manufactured housing or mobile home

 

 

b. Inheritance or court order (e.g.: divorce)

 

 

c. Vehicle purchased outside Iowa with no intent to use in Iowa. (A "move-in")

 

d. Homemade vehicle

 

e. Sales, Use, or Occupational tax paid to another state at time of purchase

 

 

f. Name dropped

 

 

g. Name added

 

 

h. Even trade or down trade

 

 

 

 

 

i. Delivered to a resident Native American Indian on the reservation

 

 

j. In-Transit title, fee to be paid in title-holder's state of residence

 

 

 

k. Transfer to or from a living or irrevocable trust

 

 

l. Other, please explain:

 

s. Salvage vehicle

 

 

 

 

Page 2 of 2

How to Edit Form 411007 Online for Free

You could complete iowa dot form 41107 without difficulty in our PDFinity® editor. FormsPal professional team is continuously endeavoring to develop the tool and enable it to be much faster for clients with its extensive features. Enjoy an ever-improving experience now! All it takes is a few basic steps:

Step 1: Simply click on the "Get Form Button" in the top section of this page to see our form editing tool. Here you'll find all that is necessary to work with your document.

Step 2: With our online PDF editor, you can actually do more than merely fill in blank form fields. Edit away and make your docs appear faultless with custom text put in, or fine-tune the file's original input to perfection - all that accompanied by an ability to add any images and sign the PDF off.

For you to complete this PDF document, be certain to type in the necessary details in each and every blank field:

1. You will want to complete the iowa dot form 41107 correctly, thus be careful when filling in the parts comprising these fields:

Stage no. 1 in filling in iowa application title registration

2. Once this part is completed, you should put in the necessary details in VEHICLE INFORMATION, VIN, Style, Year, Color, Make, Fuel, Model, Type car truck etc, Cylinders, Tonnage, GVWR, Sq Footage, Iowa Plate No If applicable, and Validation No so you're able to move forward to the third step.

Stage number 2 in submitting iowa application title registration

3. This next step should be relatively easy, Purchase Price Purchase price less, I claim exemption from payment of, List Exemption Code, I claim a business trade exemption, See Page, IWe cerify under penalty of, Signature of Owner No, Signature of Owner No, Signature of Owner No, If Firm Association Corporation or, Date, Date, Date, THE FOLLOWING FOR DEALER USE ONLY, and Less Tradein If none so state - all of these empty fields will have to be completed here.

Stage number 3 of submitting iowa application title registration

It is possible to make an error while filling in your Date, and so make sure that you go through it again prior to when you send it in.

4. To move forward, this next form section involves completing several fields. Examples of these are PRIMARY USER INFORMATION Complete, First Name, Middle Name, Primary User Check One Bona fide, Birth Date, First Name, Middle Name, Primary User Check One Bona fide, Birth Date, Last Name, If individual, Address, Address, Last Name, and If individual, which you'll find vital to moving forward with this particular process.

iowa application title registration conclusion process described (step 4)

5. This form should be wrapped up by filling in this section. Here you will see a detailed list of fields that require accurate information in order for your form usage to be faultless: UT Purchase is one of the, a Rehabilitation Facility, b Rehabilitation Facility for, c Care Facility, d Care Facility residential for, e Educational Institution Private, f Freestanding Hospice Facility, g Government, i Community Health Center, k Community Mental Health Center, m NonProfit Private Museum, o NonProfit Organ Procurement, h Hospital licensed under Iowa, j Migrant Health Center, and l Legal Aid Organization.

iowa application title registration conclusion process shown (stage 5)

Step 3: Glance through everything you've typed into the form fields and click the "Done" button. After registering afree trial account with us, it will be possible to download iowa dot form 41107 or email it at once. The PDF form will also be easily accessible from your personal account menu with all of your edits. FormsPal guarantees your data privacy by using a secure method that never saves or shares any personal information typed in. Be confident knowing your files are kept confidential every time you work with our tools!

Form 411007 isn’t the one you’re looking for?

Related Documents