TC-123, Application For Utah Duplicate Title
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Part 1 - Application for Duplicate Utah Title
Section 1 - Owner Information
Primary owner's name (last, first, middle initial or business name)
(Missing, altered, or incorrect information may result in rejected application.)
Co-owner's name (if at different street address, check here and list on back)
Street address (primary owner) Mailing address, if different from street address (primary owner)
Section 2 - Vehicle Information
Vehicle/Hull Identification Number (VIN/HIN)
Year
City City
Make
State State
ZIP code ZIP code
Model
Section 3 - Owner(s) Signature
I certify that the original certificate of title for this vehicle has been lost, stolen, mutilated, or made illegible, and has not been endorsed and delivered to a transferee, pledged as collateral, or delivered to a lending institution. I here by make application for a duplicate certificate of title and agree to indemnify the Utah State Tax Commission and all persons acting under its direction from any and all liability and shall defend, at my expense, all litigation which may arise as a result of the issuance of the duplicate certificate of title.
Owner's signature
Date
Co-owner's signature
Date
X
X
Section 4 - Lien Holder Information and Lien Release
Lien holder's name (last, first, middle initial or business name) Mailing address
Signature of lien holder (releasing interest)
X
Title
City
State
ZIP code
Date
Part 2 - Assignment and Release of Interest
Section 1 - Odometer Disclosure and Reassignment of Title (Missing, altered, or incorrect information may result in rejected application.)
Enter odometer reading (no tenths) I certify that the odometer reading (check one):
Reflects actual mileage for this vehicle Reflects the mileage in excess of odometer's mechanical limits Reading is: Miles Kilometers Is not the actual mileage (Warning: Odometer discrepancy)
(Kilometers will be converted to miles on the title.)
Date of sale
Sale price
$
As owner, I hereby transfer all rights, title, and interest to this vehicle to the new owner named below. I certify, to the best of my knowledge,
that the title is free and clear of encumbrances, except the lien to the new lien holder, if any. I certify that the odometer and sales information
provided is correct, and that any brand information recorded on the previous certificate of title has been disclosed to the new owner and lien
holder on form TC-814.
Owner's signature
Date
Co-owner's signature
Date
X
X
Section 2 - New Owner and Lien Holder Information
New owner's name (last, first, middle initial or business name)
New lien holder's name (last, first, middle initial or business name)
Street address (new owner)
Mailing address (new lien holder)
City
State
ZIP code
City
State
ZIP code
New owner's signature
X
Date
................
................
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