Notice of Lien - New York State Department of Motor …
NOTICE OF LIEN
dmv.
All information (except signature) must be typed. Verify the vehicle, hull or manufactured home ID number entered. If information is not legible, is incorrect, or not complete, the lien is NOT recorded.
VEHICLE/BOAT/MANUFACTURED HOME INFORMATION
For more information about filing a lien electronically, visit
Identification Number
Year
Make
Body Type/Hull
Registration/Plate No. of Borrower, if any
This is a:
Vehicle
Boat
Trailer
OWNER INFORMATION
Owner's Name (Last, First, Middle or Business Name)
Co-Owner's Name (Last, First, Middle or Business Name)
Current Mailing Address (Street Number and Name)
Manufactured home
Owner's NYS License/Permit/ Non-Driver ID Card Number
Co-Owner's NYS License/Permit/ Non-Driver ID Card Number
Apt. Number
City
State
Zip Code
Check here if this is a NEW address (since last issued title). Your address will ONLY be updated IF this box is checked.
NOTE: Lien will be recorded only if the name(s) listed as the owner(s) is EXACTLY the same as the owner(s) recorded, or to be recorded, on the Certificate of Title. If a Certificate of Title has not been issued to this borrower, enter the name as it appears on the driver license or non-driver ID card.
OWNER'S STATEMENT: I understand that the lienholder will send this notice to the DEPARTMENT OF MOTOR VEHICLES. If a title was previously issued in my name for this vehicle,boat , trailer or manufactured home, I gave it to the lienholder to be sent to DMV with this notice. I understand that a new Certificate of Title that shows the lienholder's name is mailed to me, at the address on record unless I have
indicated a NEW address above.
If signing for a corporation, enter your name and title:
(Name)
(Title)
OWNER(S) SIGN HERE X
(Must be an original signature. If a POA is used, a copy of the POA must be attached.)
X
(Must be an original signature. If a POA is used,
a copy of the POA must be attached.)
Date
LIEN INFORMATION
Lien Filing Code (assigned by DMV: enter only if a code has been assigned to you or your company)
Lienholder's Name
Lienholder's Name (continued) Street Address
City
State
Zip Code
This notice authorizes the Department of Motor Vehicles to disclose (or otherwise make available) information about the lienholder obtained by the department in connection with this record.
X (Lienholder's Signature--Must be an original signature or a facsimile stamp)
Date of Security Agreement
Has a NY Certificate of Title been issued to this borrower? YES
NO IFYES,ATTACHTITLE.
LIENHOLDER: Mail this form, the $5 fee paid by the lienholder payable to the Commissioner of Motor Vehicles, and the owner's title (if issued) to: TITLE BUREAU, NEW YORK STATE DEPARTMENT OF MOTOR VEHICLES, PO>BOX 2604, ALBANY NY 12220-0604
You can verify online if a lien was recorded or if a title certificate was issued. Go to the Lien/Title Certificate Status page at the DMV web site:dmv.titlestat
MV-900 (11/22)
reset/clear
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