Mvt 2 Mh Form – Fill Out and Use

APPLICATION FOR CERTIFICATE OF

TITLE FOR MANUFACTURED HOME

FEE $33.00 Payable to: Secretary of State

Check if rush requested - (additional $10.00 fee)

If manufactured home is new, attach a manufacturer’s certificate of origin to original copy; if used, attach last previous certificate of title.

T

1a.

First owner’s name (first, middle, last)

2a.

Date of Birth

 Joint ownership - If more than one owner,

common ownership will be assumed unless joint

ownership box is checked (“or” is not permitted)

1b.

Second owner’s name (first, middle, last)

2b.

Date of Birth

3.

Telephone

(

)

4.

Mailing address

________________________________________________________________________________________________________________________________________________________

Street / PO Box

City

State

ZIP

5. Legal address (If other than mailing address.)

________________________________________________________________________________________________________________________________________________________

Street / PO Box

City

State

ZIP

6. Year

7. Make

8. Model

9. Serial Number

10. Body Type

11. New

Used Rebuilt

 

12. Purchase date (Mo/Day/Yr)

13. Previous title number

14. State of origin

R

______________________

A lien holder is the institution or person financing the manufactured home. The title will be mailed to the first lien holder; if “none”, it will be mailed to the owner.

______________________

15. First lien holder’s name

If no lien, state “none”

17. Date of 1st lien

(Mo/Day/Yr)

______________________

D L O 

16. First lien holder’s mailing address: Street / PO Box

City

State

ZIP

Date:

18. Second lien holder’s name

20. Date of 2nd lien

(Mo/Day/Yr)

19. Second lien holder’s mailing address: Street / PO Box

City

State

ZIP

Approved by:

24.Maine Dealer’s Representative must sign below. The undersigned hereby certifies that the manufactured home described was sold to the owner (s) named and further certifies that the information shown is true and correct to the best of my knowledge, information, and belief.

_____________________________________________________________________________________________________________________________________ ___(__________ )______________________________

Name

Official Title

Date

Telephone

25. The undersigned hereby certify that all liens against the manufactured home described are listed and that information contained herein is true and correct to the best of my/our knowledge and belief. If under age 18 Parent or Legal Guardian must also sign. Please state relationship. If representing a company, I further certify that I have been authorized by the company to sign on their behalf. Power (s) of attorney must accompany this form.

________________________________________________________________________________________________________________________________________________________________________________

Signature of owner as named in block # 1a.All owners must sign.Signature of owner as named in block # 1b.Date

________________________________________________________________________________________________________________________________________________________________________________

Signature of Parent or Legal GuardianRelationshipDate

__________________________________________________________________________________________________________________________________________________________________________________

If owner is a company, authorized representative sign here.

Official Title

Date

A person who uses a false or fictitious name or address, makes a material false statement, fails to disclose a security interest,

or conceals any other fact on an application for certificate of title is guilty of a Class D crime.

BUREAU OF MOTOR VEHICLES TITLE SECTION

29 STATE HOUSE STATION AUGUSTA, ME 04333-0029