Mvd Mv81B Form – Fill Out and Use This PDF

1003 Buckskin Drive, Deer Lodge, MT 59722-2375

Phone (406) 846-6000 Fax (406) 846-6039

mvdtitleinfo@mt.gov

File a New Security Interest

An $8.00 fee must accompany this form in order for the security interest to be processed.

Borrower’s Statement: I acknowledge the security interest noted below and that it will be recorded on the electronic record for the above-described vehicle/vessel. I certify that, if signing for a commercial entity, I have full authority to do so.

Borrower's (1) Printed Legal Name:

Driver License Number:

Borrower's (2) Printed Legal Name:

Driver License Number:

Borrower's Address:

Is this a change of address?

Yes

No

If Yes,

Permanent change

One-time change

Secured Party's Name:

FEIN*

Secured Party's Address:

Date of Security Interest:

Amount of Security Interest: $

Borrower's Signature:

Date:

Assign/Transfer a Current Security Interest

An $8.00 fee must accompany this form in order for the security interest to be processed.

For Value Received, the Assignor named below sells, assigns and transfers to the Assignee named below, its successors and assigns, all of the right, title and interest in and to the security interest covering the vehicle/vessel described above, with power given to the Assignee to take legal proceedings in the name of Assignor or in its own name in order to enforce those rights.

Assignor: Business Name (please print):

Signature:Capacity:

(I certify that I have full authority to sign for this Assignor/Business)

Printed Name:

Date:

(if security interest is held by more than one person, all must print their name)

Assignee: Business Name (please print):

Federal Employer Identification Number or Corporate ID Number:

Address:

Signature:Capacity:

(I certify that I have full authority to sign for this Assignee/Business)

Printed Name:

Date:

(if security interest is held by more than one person, all must print their name)

Force Issuance of a Title

The certificate of title and applicable title, security interest & TRP fees must accompany this form in order for the

security interest to be processed.

I certify that: The purchaser did not apply for a title within 40 days after acquiring this vehicle/vessel and, pursuant to MCA 61-3- 220(5) and 61-3-218(2), I am paying the title fees required in MCA 61-3-203 to have the title issued to the purchaser and my security interest filed.

Purchaser’s Name:

(if a commercial entity, give full and complete name)

Driver License Number, Federal Employer Identification Number or Corporate ID Number:

Purchaser’s Address:

Secured Party’s Printed Name:									FEIN*
Secured Party’s Signature:							Official Capacity:
Date:						Check here if you wish to have the title mailed to you
										*FEIN-Federal Employer Identification Number
MV81B (4/10)		Montana county and state authorities reserve the right to reject any form that has been altered.							This form is available in alternate formats for people with disabilities.