Application for Duplicate Certificate of Title Instructions

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This form contains 25 fields organized into 8 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Applicant Signature
Applicant Signature Text
Enter the applicant's signature to certify the statements and request for a duplicate certificate of title.
Max length: 64 characters
Delivery/Mailing Information for Duplicate Title
Delivery Phone Number Text
Enter the phone number for the delivery recipient in case they need to be contacted about the duplicate title.
Max length: 26 characters
Delivery Recipient Name Text
Enter the full name of the person to whom the duplicate title should be delivered.
Max length: 51 characters
Delivery Mailing Address Text
Enter the street address or P.O. box where the duplicate title should be mailed.
Max length: 83 characters
Delivery City, State, and ZIP Text
Enter the city, state, and ZIP code for the mailing address where the duplicate title should be delivered.
Max length: 75 characters
General
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Max length: 1 characters
text_2a7f_0921 Text
Max length: 1 characters
text_bf7d_3aaf Text
Max length: 1 characters
Notary Acknowledgment Details
State of Acknowledgment Text
Enter the U.S. state where the acknowledgment is being notarized.
Max length: 16 characters
Person Appearing Before Notary Text
Enter the full name of the person who appeared before the notary for this acknowledgment.
Max length: 37 characters
Year Text
Enter the year in which the acknowledgment was taken.
Max length: 12 characters
Day of Month Text
Enter the day of the month on which the acknowledgment was taken.
Max length: 12 characters
Month Text
Enter the month in which the acknowledgment was taken.
Max length: 15 characters
County of Acknowledgment Text
Enter the county where the acknowledgment is being notarized.
Max length: 20 characters
Notary Signature and Commission Expiration
Notary Public or County Clerk Signature Text
Enter the signature of the Notary Public or County Clerk who witnessed the applicant’s signing.
Max length: 46 characters
Commission Expiration Date Date
Enter the date on which the notary’s commission expires.
Max length: 10 characters
Office Use Only
Office Use Date Date
Enter the date the office processed or received this application.
Max length: 18 characters
Receiving Number Text
Enter the office-assigned receiving number for this application.
Max length: 19 characters
Duplicate Title Number Text
Enter the duplicate title number assigned by the office for this request.
Max length: 28 characters
Original Certificate of Title Reference
Original Certificate of Title Number Text
Enter the number of the original Certificate of Title being referenced for this duplicate title application.
Max length: 25 characters
Vehicle and Owner Information
Owner Name Text
Enter the full name of the vehicle owner as it should appear on the duplicate title application.
Max length: 75 characters
Vehicle Identification Number (VIN) Text
Enter the vehicle's VIN exactly as shown on the vehicle or prior title documents.
Max length: 38 characters
Vehicle Year Text
Enter the model year of the vehicle.
Max length: 7 characters
Vehicle Make Text
Enter the manufacturer make of the vehicle (for example, Ford, Toyota, Honda).
Max length: 11 characters
Vehicle Body Type Text
Enter the vehicle body type (for example, sedan, pickup, SUV, motorcycle).
Max length: 10 characters