Application To Title/reg. A Vehicle
Download a blank fillable Application To Title/reg. A Vehicle in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Application To Title/reg. A Vehicle with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3APPLICATION TO TITLE/REG. A VEHICLE
Print Form
VALIDATION AND
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
OFFICE USE ONLY
PLATE NUMBER
YEAR
Driver and Vehicle Services Division
445 Minnesota St., St. Paul, MN 55101-5185
Phone (651) 297-2126 TTY: (651 282-6555
YEAR VALIDATION STICKER NUMBER
YEAR
dvs.dps.mn.gov
FOR CENTRAL OFFICE USE ONLY
WEIGHT STICKER NUMBER/MOTORCYCLE ENGINE NO.
A
DVS CENTRAL OFFICE USE ONLY
NEW
PREVIOUS PLATE NUMBER
YEAR
MONTH
YEAR
DATE OF PURCHASE
EXPIRATION
USED
DATE
PURCHASER(S)
COLOR CODE
TRUCKS/TRAILERS
View Color Codes
MODEL YEAR
MAKE
BODY/MODEL TYPE
OWNER(S)
DOT#
EMPTY WT.
# AXLES
BODY
ROOF
MUST
You may disclose my information for any use in
COMPLETE
VEHICLE IDENTIFICATION NUMBER
response to requests for my individual driver or
motor vehicle record.
Vehicle
You may disclose my personal information for bulk
distribution for surveys, marketing or solicitations.
Information
LAST, FIRST, MIDDLE NAME
DRIVER'S LICENSE NUMBER / DEALER NUMBER
DATE OF BIRTH
Purchaser(s)
Owner(s)
ADDITIONAL PURCHASER(S)/OWNER(S) LAST, FIRST, MIDDLE NAME
DRIVER'S LICENSE NUMBER
DATE OF BIRTH
Information
STREET ADDRESS
CITY
COUNTY CODE
STATE
ZIP CODE
DAYTIME TELEPHONE NUMBER
MINNESOTA COUNTY OR OTHER STATE WHERE VEHICLE IS KEPT
B
NO
IS THIS VEHICLE SUBJECT TO SECURITY AGREEMENT(S)? YES
IF YES, COMPLETE SECTION B.
FIRST SECURED PARTY (PRINT NAME)
DATE OF LOAN
For Additional Secured Parties,
PURCHASER(S)
Attach Completed Form PS2017
OWNER(S)
STREET ADDRESS
CITY
STATE
ZIP CODE
MUST
COMPLETE
C
ODOMETER DISCLOSURE STATEMENT. I (WE) CERTIFY THAT THE ODOMETER
DAMAGE DISCLOSURE STATEMENT. TO THE BEST OF
MY KNOWLEDGE, THIS VEHICLE:
NOW READS
(NO TENTHS) MILES AND TO THE
Has
(CHECK ONE) SUSTAINED DAMAGE IN EXCESS
SELLER(S)
BEST OF MY KNOWLEDGE, THE ODOMETER MILEAGE IS:
OF 80 PERCENT ACTUAL CASH VALUE.
Actual mileage
Has Not
MUST
In excess of odometer's mechanical limits
COMPLETE
Not actual mileage - WARNING ODOMETER DISCREPANCY
and SIGN
ASSIGNMENT: I (WE) CERTIFY THAT THIS VEHICLE IS FREE FROM ALL SECURITY INTERESTS. I (WE) WARRANT TITLE AND ASSIGN THE REGISTRATION
TAX AND VEHICLE TO THE PERSON(S)NAMED ABOVE.
SELLER'S PRINTED NAME(S)
DATE OF SALE
SELLER'S ADDRESS
DEALER LICENSE #
X
ALL SELLER'S SIGNATURE(S)
D
PURCHASER'S MOTOR VEHICLE SALES TAX DECLARATION
Base value or
WHEELAGE TAX
Gross Weight
$
1. Full purchase price
REGISTRATION TAX
Registration Period
PURCHASER(S)
2. Less trade-in allowance
PLATE FEE
From
Through
OWNER(S)
complete item #6
Change of Gross Vehicle Weight
$
ARREARS TAX
3. Net purchase price
MUST
Time of
:
Change
Hours
$
COMPLETE
% of line 3
4.
and SIGN
Date of
$
5. Less tax paid to another state
Change
PS VEHICLE FEE
$
NET SALES TAX DUE
Date
Change
Expires
TRANSFER TAX
6. Trade-in was:
MODEL YR.
MAKE
PLATE #
Change of Weight and/or Class
TITLE/TRANSFER FEE
From
To
I DECLARE
MN DEALER LICENSE #
MV SALES TAX
I (WE) CERTIFY I (WE) ARE OF LEGAL AGE, HAVE PURCHASED
THIS TAX
THIS VEHICLE SUBJECT TO LIENS SHOWN AND NO OTHER.
MN SALES TAX ACCOUNT #
LATE TRANSFER PENALTY
EXEMPTION
THIS VEHICLE IS AND WILL CONTINUE TO BE INSURED WHILE
OPERATING UPON THE PUBLIC STREETS AND HIGHWAYS. THE
CODE:
INTERNAL REV. CODE # (IRC)
VEHICLE WILL BE OPERATED IN COMPLIANCE WITH THE LAWS
SUB-TOTAL
THAT APPLY TO ITS CLASS OF REGISTRATION. I (WE) HAVE
RECEIVED A COPY OF THIS APPLICATION AND ALL OF MY
PRORATE ACCOUNT #
STATE/DEPUTY FILING FEE
(OUR) DECLARATIONS ARE TRUE AND CORRECT. IF
(Sales tax due when registered)
APPLICABLE, I (WE) HAVE KNOWLEDGE OF STATE AND
FEDERAL REGULATIONS APPLICABLE TO COMMERCIAL
TOTAL DUE
VEHICLE OPERATION, MINNESOTA STATUTES, CHAPTER 221,
WITHOUT PROPER OWNERSHIP/TRANSFER DOCUMENTS (e.g., OUT-OF-
PUBLIC SERVICE COMMISSION RULES 1 THROUGH 48 AND
STATE CERTIFICATE OF TITLE), NO MINNESOTA TITLE WILL BE ISSUED.
CODE OF FEDERAL REGULATIONS, TITLE 49, PARTS 390
THROUGH 399, AND IF A TRANSPORTER OF HAZARDOUS
X
MATERIALS, CODE OF FEDERAL REGULATIONS, TITLE 49,
PARTS 171 TO 199.
DATE
DO NOT SIGN UNTIL COMPLETE
X
DATE
ALL PURCHASERS/OWNERS MUST SIGN
PS2000-39 (11/13)
-over-
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal