STATE OF CALIFORNIA
BUSINESS, TRANSPORTATION AND HOUSING
DEPARTMENT USE ONLY
AGENCY
DEPARTMENT OF HOUSING AND COMMUNITY
NEW DECAL #
DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAMS
OLD DECAL #
APPLICATION FOR DUPLICATE
CERTIFICATE OF TITLE
Name of Manufacturer
MFG ID #
Trade Name
Model Name or #
Date of Manufacture
Calif. Dealer License #
Date of Transfer to Dealer from MFG
ILT Exemption
Date First Sold New
LENGTH
WIDTH
WEIGHT
DATE FIRST SOLD
DECAL/LICENSE
MANUFACTURER SERIAL NUMBER(S)
HUD LABEL OR HCD INSIGNIA #
(inches)
(inches)
(pounds)
(if different than above)
ADD UNITS
USE
EXPIRATION DATE
TAX TYPE
ORIG COST PRICE
CODE
YR
SALE PRICE
PPF
[ ]
CODE
DEPARTMENT
RF
ILT
EXT
LPT
PPT
USE ONLY
ILT
DTN NUMBER(S)
DTN DATE(S)
CLERK'S INITIALS
SALE DATE
Last
First
Middle
MRF
REGISTERED OWNER(S)
1.
[Print True Name(s)]
Last
First
Middle
PEN1
2.
MAILING ADDRESS
Street
City
State
Zip
PEN2
LOCATION ADDRESS
Street
City
State
Zip
OF UNIT
TRF
LEGAL OWNER
[Print True Name(s)]
TOD
MAILING ADDRESS
Street
City
State
Zip
DUPT
APPLICATION FOR TRANSFER BY NEW OWNERS
SUBD
I/We request that the new Certificate of Title and Registration Card to be issued as follows:
REGISTERED OWNER(S)
CONF
1.
[Print True Name(s)]
REPO
2.
RREG
3.
If applicable, check one of the following:
[ ] TENCOM OR
[ ] JTRS
[ ] TENCOM AND
[ ] COMPRO
[ ] COMPRORS
RSF
MAILING ADDRESS
Street
City
State
Zip
PLT
FUTURE MAILING
Street
City
State
Zip
SIT
ADDRESS
LOCATION ADDRESS
Street
City
State
Zip
UTP
RT
OF UNIT
ASF
LEGAL OWNER
[Print True Name(s)]
CCP
If applicable, check one of the following:
[ ] TENCOM OR
[ ] JTRS
[ ] TENCOM AND
[ ] COMPRO
[ ] COMPRORS
TOTAL
MAILING ADDRESS
Street
City
State
Zip
FIRST JUNIOR
LIENHOLDER
[Print True Name(s)]
If applicable, check one of the following:
[ ] TENCOM OR
[ ] JTRS
[ ] TENCOM AND
[ ] COMPRO
[ ] COMPRORS
MAILING ADDRESS
Street
City
State
Zip
ADD JR/LH [ ]
Note: Section I, "CERTIFICATION OF MISSING TITLE" ON THE REVERSE SIDE MUST BE COMPLETED. TO COMPLETE A TRANSFER OF OWNERSHIP,
BOTH THE OLD AND NEW OWNERS MUST SIGN THE APPROPRIATE LINES ON THE REVERSE SIDE OF THIS FORM.
HCD 480.4 - Side 1 (REV 09/07)