
New
Change of ownership
Change of lienholder
Corrected title
Salvage title
Non-repairable title
Dismantling permit
Section 1: New Owner Name Information If more than two owners, check here
and list on back. Relationship to co-owner:
And
Or
Primary owner’s ID number (required) ID type:
Drivers license
Passport State/Country Co-owner’s ID number (required) ID type:
Drivers license
Passport State/Country
State ID
FEIN
State ID
FEIN
Military ID
Foreign ID
Military ID
Foreign ID
Primary owner’s name (last, first, middle initial, or business name) Email address Co-owner’s name (if at different street address, check here
and list on back)
Street address (primary owner) City State ZIP code
Mailing address, if different from street address (primary owner) City State ZIP code
Section 2: New Lessee Information If more than two lessees, check here
and list on back. Relationship to co-lesee:
And
Or
Primary lessee’s ID number (required) ID type:
Drivers license
Passport State/Country Co-lessee’s ID number (required) ID type:
Drivers license
Passport State/Country
State ID
FEIN
State ID
FEIN
Military ID
Foreign ID
Military ID
Foreign ID
Lessee’s name (last, first, middle initial, or business name) Co-lessee’s name (if at different street address, check here
and list on back)
Street address (primary lessee) City State ZIP code
Mailing address, if different from street address (primary lessee) City State ZIP code
Section 3: Vehicle Information (Note: Missing or incorrect information may result in a rejected application.)
Passenger, light truck, van, or utility
Street motorcycle
Small motor vehicles (CC_______ HP_______ )
Motor home (Length: _____ ft. _____ in.) (Class______ )
Off-highway vehicle (check one:
ATV
Motorcycle)
Low-speed vehicle
Street-legal ATV
Roadable aircraft
Snowmobile
Manufactured housing
Heavy truck (Registered weight: ______________ )
Commercial vehicle with registered weight of at least
10,001 lbs? Enter your USDOT #: _____________
Trailer:
Camper
Park model
Tent
Travel
Utility
Other trailer: ___________________ No. of axles: _____ Trailer length: _____ ft. _____ in.
Section 4: Registration Information
License plate type (You may request a personalized plate after we issue the initial plate. Go to mvp.tax.utah.gov. Additional fees will apply.)
Title only
In God We Trust
Life Elevated Arches
Life Elevated Skier
Transfer:
__________
Other:
___________
Situs/Physical address of vehicle, if different from street address above City State ZIP code
Contribute $2 to:
Friends for Sight
Organ Donation Support Contribute $3 to:
Emergency Medical/Search & Rescue
Section 5: Lien Holder Information
Lien holder’s name Email address FEIN (or driver’s license no., if individual) Branch number
Mailing address City State Zip code
Section 6: Owner Signature(s)
I declare that I am the owner of the vehicle described on this application and all the above information is accurate and true. I certify that I will maintain in effect owner’s
or operator’s security (insurance) for this vehicle, as required by law, in order to operate this vehicle on a highway, quasi-public road, or parking area within this state.
Owner’s signature Date Co-owner’s signature Date
X X
Section 7: Purchase and Dealer Information (For Utah Dealership Use Only)
I certify that the vehicle is accurately described on this application and has been delivered to the purchaser named above and that this dealership is in compliance with
the licensing requirements set forth in Title 41, Chapter 3, Part 2 of the Utah Code. I also certify that this transaction was completed in compliance with the sales tax
reporting requirements set forth in Section 59-12-107 of the Utah Code.
Purchase date Dealer number
New
Used
Permit number Permit issue date Dealer/Authorized representative’s signature Date
X
Year Make Model
Commercial use
? Farm use?
Yes
No
Yes
No
Vehicle Identification Number (VIN) Cylinders Fuel type
Color Fleet number Unit n
umber
Body type (trailers) If branded title, brand type MSRP Purchase price
$ $
I certify that the odometer reading (check one):
Reflects actual mileage for this vehicle
Reflects the mileage in excess of odometer’s mechanical limits
Is not the actual mileage (Warning: Odometer discrepancy)
Enter odometer reading (no tenths)
Reading is:
Miles
Kilometers
(Kilometers will be converted to miles on the title.)