Form VSA 66 at a glance
What it is: Form VSA 66 (12/20/2016), the Application for Transfer and Supplemental Liens: use this form to apply for a lien transfer or a supplemental lien.
Who signs: Owners must sign when application is made for a supplemental lien. Lienholders must sign when transferring a lien.
A filled-in Form VSA 66 example: a lien moves to a new lender
How to fill out Form VSA 66, box by box
Application type
Check one. For Transfer of Lien, submit an original title unless the lienholder is a participant in the electronic title program, and complete sections (1) Owner Information, (2) Vehicle Information, (3) Current Lien Information, (4) Transfer of Lien, and (6) Certification.
For Supplemental Lien, submit an original title unless the new lienholder is the same as the old lienholder and the lienholder is a participant in the electronic title program, and complete sections (1) Owner Information, (2) Vehicle Information, (3) Current Lien Information, (5) Supplemental Lien, and (6) Certification.
1. Owner Information
Enter the owner full legal name (last, first, middle, suffix), the DMV customer number / FEIN / SSN and the telephone number.
If there is a co-owner, enter the co-owner full legal name (last, first, middle, suffix), the DMV customer number / FEIN / SSN and the telephone number.
Enter the mailing address, city or town, state and zip code.
Mark YES or NO: Are any of the vehicle owners on active military duty or service?
2. Vehicle Information
Enter the vehicle identification number (VIN).
Enter the title number, plate number, plate type, year, make, model, body type and weight.
3. Current Lien Information
Check one: Printed original paper title certificate attached, or Original title certificate is electronic title (no paper title attached).
For the FIRST LIEN, enter the lien date (mm/dd/yyyy), lienholder name, lienholder code, lienholder mailing address, city or town, zip code and state.
For the SECOND LIEN, enter the lien date (mm/dd/yyyy), lienholder name, lienholder code, lienholder mailing address, city or town, zip code and state.
4. Transfer of Lien
Complete this section only to transfer a lien to a new lienholder.
Enter the date of lien filing (mm/dd/yyyy), the new lienholder name, the lienholder code, the mailing address, city or town, zip code and state.
5. Supplemental Lien
Complete this section to add a lien. The priority of the security interest will be determined according to the date of the application filing (Virginia Code § 46.2-637).
Enter the date of lien filing (mm/dd/yyyy), the lienholder name, the lienholder code, the mailing address, city or town, zip code and state.
6. Certification
You make application for a title certificate for the vehicle described herein and certify and affirm that all information presented in this form is true and correct, that any documents you have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate.
You make this certification and affirmation under penalty of perjury, and knowingly making a false statement or representation on this form is a criminal violation.
Owners must sign when application is made for a supplemental lien: sign on the Owner Signature line and, if there is a co-owner, on the Co-Owner Signature line, each with the date (mm/dd/yyyy).
Lienholders must sign when transferring a lien: enter the Current Lienholder Name (print) and the New Lien Holder Name (print), each with its signature line and the date (mm/dd/yyyy).
More rules for Form VSA 66
Any person who refuses to supply the required information will be denied a Certificate of Title and/or registration.
Common questions about Form VSA 66
Who signs it?
Owners must sign when application is made for a supplemental lien. Lienholders must sign when transferring a lien.
Where do I file it?
Submit the form to any DMV customer service center with the appropriate fees, or mail the form and fees to the Titling Work Center.
Sources
[1] Form VSA 66 (12/20/2016), Application for Transfer and Supplemental Liens, Virginia Department of Motor Vehicles (the Official source link on this page).
