Form Mvr 4 PDF Details

Form MVR 4 is an important document for motorists in the state of Maryland. This form is used to report changes to your driving record, such as license suspensions or moving violations. It's important to keep your driving record up-to-date, so make sure to submit a Form MVR 4 whenever there are changes. For more information on this form and how to submit it, please visit our website.

You will discover details about the type of form you would like to fill out in the table. It will show you the span of time you'll need to complete form mvr 4, what parts you will have to fill in, and so forth.

QuestionAnswer
Form NameForm Mvr 4
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesmvr 4, lost title form nc, form mvr 4, lost title form nc dmv

Form Preview Example

MVR-4 (Rev. 08/12)

North Carolina Division of Motor Vehicles

$15.00 Fee

There is a 15-day mandatory waiting period after an application for duplicate title is received by the Division of Motor Vehicles before a certificate of title can be issued. Mail Back to: NCDMV, 3148 Mail Service Center, Raleigh, NC 27699.

VEHICLE DESCRIPTIONTitle No.__________________________________________

Year ________________ Make ______________________ Body Style___________________ Series Model __________________________

Vehicle Identification Number ____________________________________________________________ Fuel Type ____________________

Name of Registered Owner(s) __________________________________________________________________________________________________________

First NameMiddle NameLast Name

___________________________________________________________________________________________________________________________________

Residential AddressCityStateZip CodeCounty

Mailing Address _____________________________________________________________________________________________________________________

(IF DIFFERENT FROM ABOVE)

Vehicle Location Address _____________________________________________________________________________________________________________

(IF DIFFERENT FROM ABOVE)

LIEN RECORD AS SHOWN ON ORIGINAL TITLE

First Lien __________________________________________________________________________________________________________________________

DateLien HolderAddress

Second Lien ________________________________________________________________________________________________________________________

DateLien HolderAddress

Third Lien __________________________________________________________________________________________________________________________

Date

Lien Holder

Address

DISCLOSURE SECTION

All motor vehicle records maintained by the North Carolina Division of Motor Vehicles will remain closed for marketing and solicitation unless the block below is checked.

I (We) would like the personal information contained in this application to be available for disclosure.

CHECK APPLICABLE BLOCK

Application for Duplicate Certificate of Title and Assignment by Registered Owner

Application for Duplicate Certificate of Title as Recorded

Application for Duplicate Certificate of Title and Removal of Lien

If original title was issued subject to a lien and it has been satisfied, lien holder must certify to that effect.

I/we, the registered owner(s) of the above described vehicle, hereby make application for a duplicate certificate of title and certify that the original has been:

(Check applicable block) Lost

Never Received

I understand that upon issuance of the duplicate, the original title becomes void and that I am required to return the original title to the Division of Motor Vehicles immediately should it be found.

Current Odometer Reading

I (we) certify that the information on the application is correct to the best of my (our) knowledge.

Signature(s) of registered owner(s) _____________________________________________________________________________________________________

Date____________________________ County __________________________________________ State __________________________________________

I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: ______________________________________________________________(name(s) of principal(s)).

Notary

Notary Printed

Signature______________________________________________________________

or Typed Name ____________________________________________

(SEAL)

My Commission Expires ____________________________________

AFFIDAVIT OF FIRST LIEN HOLDER

I/we, support the application for a duplicate certificate of title covering the above described vehicle and certify that the original title was:

 

 

(CHECK APPLICABLE BLOCK)

Title lost while in my possession; lien has been satisfied

Lost while in my possession

 

 

 

 

Never Received

Surrendered to _________________________________________________ upon payment of lien in full.

 

 

 

 

Lien holder’s signature by: ______________________________________________________________________________________________

 

 

 

 

Date ______________________________

County ________________________________________ State ___________________________________________

 

 

 

 

I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document

 

 

 

 

for the purpose stated therein and in the capacity indicated: ______________________________________________________________(name(s) of principal(s)).

 

 

 

 

Notary

 

Notary Printed

 

 

 

 

 

Signature______________________________________________________________ or Typed Name ____________________________________________

 

 

 

 

 

(SEAL)

My Commission Expires ____________________________________

 

 

*

 

 

 

 

 

 

 

 

 

 

 

 

 

The duplicate title will be issued subject to such liens as were recorded on the last title and mailed to the first lien holder of record, unless lien release is submitted.

 

 

 

The lien holder may apply for a duplicate title, without the signature(s) of the registered owner(s), if the original title was lost while in the lien holder’s possession.

 

 

 

When a title, mailed to a lien holder by the Division of Motor Vehicles, is not received, affidavits by the registered owner(s) and lien holder(s) are required in order to

 

 

o obtain a duplicate title.

 

 

 

 

 

 

 

 

 

 

 

 

 

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stage 1 to completing form mvr 4

Fill in the All motor vehicle records, I We would like the personal, CHECK APPLICABLE BLOCK, Date County State I certify that, Notary Printed, SEAL, My Commission Expires, AFFIDAVIT OF FIRST LIEN HOLDER, Title lost while in my possession, and Iwe support the application for a space with the data demanded by the platform.

form mvr 4 All motor vehicle records, I We would like the personal, CHECK APPLICABLE BLOCK, Date County State I certify that, Notary Printed, SEAL, My Commission Expires, AFFIDAVIT OF FIRST LIEN HOLDER, Title lost while in my possession, and Iwe support the application for a blanks to fill

In the Title lost while in my possession, Surrendered to upon payment of, Iwe support the application for a, Notary Printed, SEAL, My Commission Expires, and The duplicate title will be section, highlight the significant data.

form mvr 4 Title lost while in my possession, Surrendered to upon payment of, Iwe support the application for a, Notary Printed, SEAL, My Commission Expires, and The duplicate title will be fields to fill

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