The 78 003 10 1 1 000 form is a vital document for those seeking to transfer the ownership of a motor vehicle in the state of Mississippi. This Power of Attorney to Transfer Motor Vehicle form not only facilitates the legal transfer of a vehicle's title but also accompanies the certificate of title as a supporting document for new or replacement title applications. It requires the vehicle owner, the grantor, to appoint a trusted individual as their attorney-in-fact, granting them the authority to sell, transfer, and assign the motor vehicle on their behalf. The form meticulously outlines the responsibilities of this appointed attorney, including the necessity to adhere to federal and state laws regarding the disclosure of the vehicle's mileage at the time of transfer. Failure to accurately disclose the odometer reading can attract severe penalties, underscoring the importance of honesty and precision in completing this section of the form. It ends with a space for the grantor's signature, effectively validating the document in the presence of a notary, further emphasizing the form's legal importance. The 78 003 10 1 1 000 form is an essential document for vehicle owners in Mississippi, streamlining the process of legally transferring vehicle ownership while ensuring compliance with federal and state regulations.
| Question | Answer |
|---|---|
| Form Name | Form 78 003 10 1 1 000 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | ms 1 motor vehicle, mississippi power of attorney to transfer motor vehicle, form 78 003, power transfer motor vehicle |
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POWER OF ATTORNEY TO TRANSFER MOTOR VEHICLE |
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This document shall pass with the certificate of title and be included as a support document |
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to application for new certificate of title and/or application for replacement certificate of title. |
FORM |
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THE STATE OF MISSISSIPPI |
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COUNTY OF _______________________ |
KNOW ALL MEN BY THESE PRESENT: |
THAT I, __________________________________________________________________________________________________
GRANTOR, NAME TO APPEAR IN SAME FORM AS CONTAINED IN CERTIFICATE OF TITLE
________________________________________________________________________________________, OF THE COUNTY OF
(ADDRESS)
________________________________________________________________________and the STATE OF MISSISSIPPI, owner of
the following described motor vehicle, have made, constituted and appointed and by these present do make, constitute and appoint
___________________________________________________________________________________________________________
________________________________________________________________________________________, OF THE COUNTY OF
(ADDRESS)
________________________________________________________________________ and the STATE OF MISSISSIPPI, my true
and lawful attorney, for me and in my name, place and stead to sell, transfer and assign the motor vehicle described as follows to wit:
MAKE____________________________ V.I.N.___________________________________________
YEAR____________________________ BODY TYPE_____________________________________
TITLE NUMBER______________________________
giving and granting unto my said attorney full power and authority to do and perform all and every act requisite and necessary to transfer and assign the legal title to said motor vehicle to anyone whomever, as may be designated by said attorney.
FEDERAL and STATE LAW requires that you state the mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result in fines and / or imprisonment.
I certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked.
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_____ 1. |
I hereby certify that the mileage state is in excess of the mechanical limits of |
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Odometer Reading |
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the odometer. |
(No Tenths) |
_____ 2. |
The odometer reading is not actual mileage. |
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IN WITNESS WHEREOF I HAVE hereunto set my hand this __________________________day of _______________,
20_______ .
______________________________________________________________________
Signature of Owner, Grantor
______________________________________________________________________
Printed Name of Grantor (if Title is in Company Name, include appropriate Title, Partner, President, Sec. Treas., etc.)
Before me, the undersigned authority, on this day personally appeared_________________________________________________
(Individual Name Only)
known to me to be the person whose name is subscribed to the above foregoing instrument, and acknowledge to me that he executed the same for the purposes and consideration therein expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE THIS________________________day of ________________A.D.,
20________.
________________________________________________________
Notary Public
Title Bureau, |
P. O. Box 1383, |
Jackson, MS 39215 |
www.dor.ms.gov |
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Fax |