Request for Motor Vehicle or Boat Record that Includes ...



Mail to:PO Box 2014, Frankfort KY 40601-2014TO BE COMPLETED BY A GOVERNMENTAL AGENCYThis information is requested solely for the benefit and use of carrying out the functions of a government agency.Note: Title records older than five years are not available.Select all applicable boxes. FORMCHECKBOX Odometer or Mileage Discrepancy FORMCHECKBOX Copy of Certificate of Origin FORMCHECKBOX Signature Verifications FORMCHECKBOX Copy of O/S Title FORMCHECKBOX Tax Purposes FORMCHECKBOX Copy of VTR or Supporting Documents FORMCHECKBOX Owner Information FORMCHECKBOX Copy of Current Title FORMCHECKBOX Clerk Error or Correction FORMCHECKBOX Certify Documents FORMCHECKBOX Transfer Dates FORMCHECKBOX Court Documents FORMCHECKBOX Complete History FORMCHECKBOX Other (Specify.) FORMTEXT ?????VIN or HIN Number FORMTEXT ?????Title FORMTEXT ?????License Plate FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Printed Name of Person Making RequestAgency or Company (if applicable) FORMTEXT ?????SignatureDateAddressSTATE OF FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????COUNTY OF FORMTEXT ?????City FORMTEXT ?????StateZip FORMTEXT ?????Attested before me on thisday of20Email AddressPhone FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????DL #Unit # Badge # FORMTEXT ?????Notary/Attesting Official Signature & TitleState of Issuance OR Fed Tax ID #FOR MVL USE ONLY:My commission #:Expiration://Date Processed: FORMTEXT ?????MMDDYYYYClerk’s Initials: FORMTEXT ????? ................
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