Ps2067A 15 Form PDF Details

When vehicle owners in Minnesota encounter the need to replace their vehicle's title, registration card, cab card, or lien card, they turn to the PS2067A-15 form, a critical document provided by the Minnesota Department of Public Safety, Driver and Vehicle Services. Located at 445 Minnesota Street in St. Paul, this department facilitates the issuance of duplicates for these essential documents. The process outlined in the form is straightforward, yet requires careful attention to detail, including declaring the reason for the replacement (such as the original being stolen, mutilated, destroyed, illegible, lost, not received, or given to the buyer under specific circumstances). The application must be accompanied by the applicable fees and, under certain conditions, requires the original document - if available in a mutilated or illegible state - to be attached. Additionally, the form highlights the necessity of a notarized lien release for freeing a security interest on the vehicle by the secured party. Moreover, it provides instructions for cases where the document needs to be sent to a temporary address. A key caveat is that the Minnesota Department of Public Safety will only issue a duplicate title to the owner or their legal representative, emphasizing the importance of returning the original title if it is later recovered and clarifying the implications of failing to provide required data, which could obstruct the ownership transfer or registration of the vehicle. This form embodies an intricate blend of process, legal necessity, and attention to procedural details, all aiming to safeguard vehicle ownership records and the interests of all parties involved.

QuestionAnswer
Form NamePs2067A 15 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesehicle, writeable title car mn, ILLEGIBLE, form ps2067a 15

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M I N N E S O T A D E P A R T M E N T O F P U B L I C S A F E T Y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D r i v e r a n d V e h i c l e S e r v i c e s

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

445 Minnesota Street, St. Paul, MN

55101-5187

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone: 651-297-2126

TTY: (651) 282-6555

 

Web: www.mndriveinfo.org

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICATION FOR DUPLICATE TITLE, REGISTRATION, CAB OR LIEN CARD

 

 

 

 

 

 

 

 

 

 

 

PLEASE READ THE INSTRUCTIONS AT THE BOTTOM OF THIS PAGE BEFORE COMPLETING

 

 

 

 

 

 

 

 

 

 

 

 

 

Duplicate plates and stickers ARE NOT required when applying for duplicate title

 

 

 

 

 

 

 

FOR OFFICIAL USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLE NUMBER OF MISSING DOCUMENT

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

2

3

4

5

6

7

8

 

9

10

11

12

 

13

14

15

16

 

17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLATE NUMBER

PLATE YR.

MAKE

 

MOD. YR.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR CENTRAL OFFICE USE ONLY

PRINT

FIRST

LAST, FIRST, AND MIDDLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S LICENSE NO.

 

 

 

DATE OF BIRTH

APPLICANT’S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FULL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDITIONAL

LAST, FIRST, AND MIDDLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S LICENSE NO.

 

 

 

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

OWNER’S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRINT ADDRESS OF

STREET

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

COUNTY

 

 

 

STATE

ZIP

FIRST OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(PERMANENT ADDRESS)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS APPLICATION IS FOR A DUPLICATE (Please check one):

TITLE

REG. CARD

CAB CARD

LIEN CARD

Check the box that indicates why the document must be replaced:

 

 

 

 

STOLEN

MUTILATED – Attach the mutilated document

 

 

 

DESTROYED

ILLEGIBLE – Attach the illegible document

 

 

 

LOST

NOT RECEIVED (Your lending institution or the postal service may have the missing document)

GIVEN TO BUYER (SELLER IS FILING AFFIDAVIT OF SALE)

 

 

 

 

FEES DUE

$

¢

DUPLICATE

FILING

$

¢

TOTAL

Temporary Address: Attach a SELF-ADDRESSED, STAMPED ENVELOPE if the document must be sent to a temporary address, and print that address here.

STREET

CITY

STATE

ZIP CODE

Please Check One:

Applicant is the Owner (if jointly owned, only owner’s signature is required)

Applicant is Secured Party

I certify that all of my declarations are true and correct. I am the owner or secured party of this vehicle and the original document has not been assigned and/or surrendered to anyone.

X

 

 

X

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

Applicant(s) signature(s)

 

 

 

 

Applicant(s) signature(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title of Agent if Applicant is Secured Party:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIEN RELEASE – Print name and address of lien holder

- NOTICE -

 

 

Subscribed and sworn to before me

SECURED PARTY’S NAME

 

 

 

 

 

Secured party’s signature

 

 

this

 

 

 

 

 

 

 

 

 

 

 

 

 

must be notarized to release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day of

 

20

 

 

 

 

 

 

 

 

 

 

a lien.

 

 

 

 

 

 

STREET ADDRESS

MINNESOTA TAX ID NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTARY PUBLIC

 

CITY

STATE

 

 

ZIP CODE

The se cured party named no longer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

claims a security interest in the vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

described above.

 

 

 

 

COUNTY

 

SIGNATURE AND TITLE OF AUTHORIZED AGENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MY COMMISSION EXPIRES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTRUCTIONS: PLEASE READ CAREFULLY BEFORE COMPLETING

1.Duplicate plates and stickers ARE NOT required when applying for a duplicate title, registration/cab card or lien card. You only need to complete this side of the form.

2.Fees: Please contact DVS or your local deputy registration to determine fees or for assistance in completing this form. If you are applying by mail, make remittance payable to: Driver and Vehicle Services.

IMPORTANT NOTICE: PLEASE READ

DVS will issue a duplicate certificate of title only to the owner or legal representative (power of attorney is required) of the owner named on the original certificate. If the original certificate of title is recovered, it must be returned to DVS.

All data collected on a motor vehicle application are required by law. These data are used to identify your motor vehicle. Failure to provide required data may result in denial of the transfer of ownership, registration of this vehicle, or other requested action. Except for certain uses permitted by federal and state laws, personal information contained in your application may not be disclosed to anyone without your express consent.

PS2067A-15

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Step # 1 in submitting PS2067A-15

2. Soon after the prior section is filled out, go to type in the suitable information in these: Please Check One, Applicant is the Owner if jointly, Applicant is Secured Party, I certify that all of my, anyone X Applicants signatures, Applicants signatures, Title of Agent if Applicant is, LIEN RELEASE Print name and, STREET ADDRESS, MINNESOTA TAX ID NO, CITY, STATE, ZIP CODE, SIGNATURE AND TITLE OF AUTHORIZED, and DATE.

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