NC MVR 330 Form – Fill Out and Use This PDF

CHECK Appropriate Block/s (Application cannot be processed without certification of services)

I certify that all the above information is correct. ___________ (Customer’s Initials)

VEHICLE SECTION

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.

LESSEE SECTION

I, (We) certify that the described vehicle is leased from the owner and that this vehicle is to be used by me and that the information on the application is correct to the best of my (our) knowledge. I further certify the above listed vehicle is properly insured as required under G.S. 20-

309 by:

Signature of lessee ____________________________________________________________________________________________________

(Must be personally signed in ink by the lessee; if firm or corporation, by one of its authorized representatives, or, if in joint ownership, signature by each must be affixed)

LESSOR CERTIFICATION SECTION

As owner of the above described motor vehicle, I do certify that it has been leased to the person, firm or corporation whose name appears as lessee and further certify that it is being used by such lessee. Consent for the licensing of this vehicle in the name of the lessee is hereby given. The vehicle is properly insured, by the company listed above, as required by G.S. 20-309.

Signature of lessor __________________________________________________________________________________________________________________

(Must be personally signed in ink by the lessor; if firm or corporation, by one of its authorized representatives, or, if in joint ownership, signature by each must be affixed)

Instructions: A certificate of title must be vested and recorded in the name of the owner before a registration plate can be issued. If the vehicle is owned by a nonresident and is registered in a state other than North Carolina, the certificate of title, or registration certificate, must accompany this application. Proof of financial responsibility is required.