North Carolina Division of Motor Vehicles Process for Used ...

MVR-412 (Rev. 12-18)

North Carolina Division of Motor Vehicles

Process for Used Motor Vehicle Dealers to dispose of abandoned vehicles received from Charitable Organizations.

G.S. 20-109.3 provides a process for used motor vehicle dealers to dispose of abandoned vehicles received from charitable organizations. This form is required when the motor vehicle certificate of title is unavailable, and the vehicle has been donated to a charitable organization.

Dealership: ______________________________________ Dealer Number:________ Charitable Organization: _________________________________________________ Location of Vehicle: _____________________________________________________ Vehicle Description: VIN__________________________________________________________ Year________ Make________ Model__________ Body Style___________ Fuel__________ Last Known Owner: __________________________________________________________ Last Known Lienholder: _______________________________________________________

Required Documentation

The following documentation must accompany this form to allow the Division to issue a title for the vehicle that has been donated to a charitable organization.

1) Proof of the Notice which was sent to last registered owner and lienholder (if applicable) 2) Proof of Delivery of required Notice* 3) Duplicate Title with transfer (MVR-4) 4) Duplicate Title Fees 5) Power of Attorney for motor vehicle dealer to act on behalf of charitable organization.

*The notice was sent certified mail or other commercial delivery service. 30 Days is defined as calendar days, starting from the date the notice was mailed to the last registered owner and lienholder.

SWORN CERTIFICATION OF DEALER REPRESENTATIVE

The signatory below, first being duly sworn and in accordance with G.S. 52.1(d), G.S. 20-72(b), and G.S. 20-72.1(a), hereby certifies that to the best of the signatory's knowledge and information as of the date of this certification, that the previous known owners and lienholders have been contacted and they have not made any claim to take possession of this vehicle within the days allowed by law.

I declare the foregoing is true and correct:

_______________________________________________________________

Signature of Dealer Principal, General Manager, General Sales Manager, Controller, or Owner

________________20__

Date

State of North Carolina County of _____________________ Sworn and subscribed before me on the _______day of _____________, ________ by ________________________________________

Print name Notary Signature ___________________________________________________

Notary printed or typed name ___________________________________________________

(SEAL)

My Commission Expires ________________________________________

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