AUTHORIZATION FOR PAYMENT and TITLE RELEASE
Daimler Truck Financial
AUTHORIZATION FOR PAYMENT and TITLE RELEASE
The undersigned authorizes Mercedes-Benz Financial Services USA LLC and Daimler Trust to release and deliver the bill of sale, vehicle title and other related paperwork on the following vehicle to the Payor named below:
STEP 1 Account Name: ______________________________________________________
Account #: __________________________________________________________
Year: __________ Model: __________________________________________
STEP 2
VIN: ________________________________________________________________ Please deliver to:
COMPANY NAME: ______________________________________________________
NAME: _______________________________________________________________
PHYSICAL ADDRESS: ___________________________________________________ (May not use P.O. Box or Rural Route for overnight delivery*)
________________________ CITY
____________ ST
____________ ZIP
PLEASE PROVIDE YOUR OVERNIGHT CARRIER ACCOUNT #
____________ Federal Express
____________ DHL
____________ UPS Next Day Air
STEP 3 TO BE SIGNED BY MERCEDES-BENZ FINANCIAL SERVICES USA LLC AND/OR DAIMLER TRUST CUSTOMER
The release of the Title to the Payor is conditional upon payment in full by Payor of the Retail Installment Contract-Security Agreement held by you regarding this vehicle.
This Title will ONLY be assigned to our Customer or Authorized Dealer. (This document must be signed by a party listed on the Contract)
Customer Name (Printed): ____________________________________________________________
Customer Signature: _________________________________________________________________
Title (if applicable): __________________________________________________________________
Date: ______________________________________________________________________________
Complete and return by email to DTF-ART@
Insert customer name and full VIN in email subject line to expedite processing. If wiring money, please provide the name of the Payor and the amount wired.
This form is void after 90 days from date indicated above
TFFF3029 (08/07/2015)
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