NOTICE OF LIEN
PLEASE PERFECT YOUR LIEN IMMEDIATELY!
IMPORTANT: Liens must be filed and/or received with the Department within 30 days of the loan date (perfected) for the lienholder to be protected from the debtor filing for bankruptcy relief.
A $6.00 processing fee must be submitted with each Notice of Lien.
OWNER INFORMATION AND UNIT DESCRIPTION — Complete all applicable blocks.
FIRST LIEN — Complete the FIRST LIENHOLDER INFORMATION section, if applicable.
SECOND LIEN — Complete the FIRST and SECOND LIENHOLDER INFORMATION sections, if applicable.
First Lienholder Authorization — This block must be signed by the first lienholder when adding a second lien.
Checks may be accepted as payment. Make checks payable to: Missouri Department of Revenue. The check must be pre-printed with the check writer’s name, address, bank code, and account number. It must also include the following information regarding the check writer:
1.Driver license or non-driver license number;
2.Date of birth; and
3.Daytime phone number.
Other restrictions may apply. NOTE: The Missouri Department of Revenue may electronically resubmit checks returned for insufficient or uncollected funds.
The lienholder will receive a receipt as proof the lien has been perfected.
Submit the completed Notice of Lien (Form 4809) to your local license office or by mail to the following address:
MOTOR VEHICLE BUREAU
301 WEST HIGH STREET
PO BOX 3355
JEFFERSON CITY MO 65105-3355
OWNER INFORMATION AND UNIT DESCRIPTION SECTIONS — Complete all applicable blocks.
FIRST AND SECOND LIENHOLDER SECTIONS — Leave blank.
LIEN RELEASE SECTION — Enter the lienholder’s name as shown on title, the date of release, printed name of the lienholder’s agent, and signature of lienholder’s agent.
NOTARIZATION — The notary information is required to be completed to release the lien.
NOTE: License Office notary service - $2.00
FRAUDULENT LIEN RELEASE — ANY PERSON WHO KNOWINGLY AND INTENTIONALLY SUBMITS A SEPARATE DOCUMENT RELEASING A LIEN OF ANOTHER WITHOUT THE AUTHORITY TO DO SO SHALL BE GUILTY OF A CLASS D FELONY. (301.640, RSMo)