Form 130-U - Application For Texas Title
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1
2APPLICATION FOR TEXAS TITLE
TYPE OR PRINT NEATLY IN INK
TAX OFFICE USE ONLY
Standard Presumptive Value
SPV $
Tax Collector:
County:
Date:
Transaction Number:
Appraisal Value $
1. Vehicle Identification Number
2. Year
3. Make
4. Body Style
5. Model
6. Major Color
7. Minor Color
8. Plate No.
9. Odometer Reading (no tenths) 10. This is the Actual mileage unless one of the following is checked:
Exempt
BVD5576
N- Not Actual Mileage (WARNING-ODOMETER DISCREPANCY)
X- Mileage Exceeds Mechanical Limits
11. Empty Weight
12. Carrying Capacity (if any)
13. For corrected title, check reason(s):
Make
Body Style
Model
Change in Vehicle Description
VIN
Year
Add Lien
Remove Lien
Other
Odometer Reading
Odometer Brand
14. Applicant Type
Individual
Business
Government
Trust
Non-Profit
First Applicant/Owner Photo ID Number
or FEIN/EIN
15. ID Type
(State/Territory)
(Country)
U.S. Driver's License/ID Card
Passport
U.S. Military ID
NATO ID
Other Military Status of Forces Photo ID
U.S. Citizenship & Immigration Services/DOJ ID
U.S. Department of State ID
U.S. Department of Homeland Security ID
16a. Applicant/Owner Legal Name
First
Middle
Last
Suffix (if any)
16b. Entity Name
17. Owner County of Residence
18. Additional Owner Name (if applicable)
First
Middle
Last
Suffix (if any)
19. Mailing Address
City
State
Zip
20. Previous Owner Name/Business Name
City
State
Dealer GDN (if applicable) Unit No.(if applicable)
21. Renewal Recipient Name (if different)
First
Middle
Last
Suffix (if any)
22. Renewal Mailing Address (if different)
City
State
Zip
City
State
Zip
23. Vehicle Location Address (if different)
24. First Lien Date
25. Lienholder Name (first)
26. Certified Lienholder ID No.
27. Electronic Title Request?
(Cannot check # 28)
MEMBERS CHOICE CREDIT UNION
74188652400
28. Additional Lien(s)?
(Attach Form VTR-267)
City
State
Zip
29. Lienholder Mailing Address
14960 PARK ROW BLVD
HOUSTON
77084
TX
30. Check only if applicable:
MOTOR VEHICLE TAX STATEMENT
and will satisfy the minimum tax liability (V.A.T.S., Tax Code, §152.046 [c]).
I hold Motor Vehicle Retailer's (Rental) Permit No.
I am a dealer or lessor and qualify to take the Fair Market Value Deduction (V.A.T.S., Tax Code, §152.002 [c]).
GDN or Lessor Number
31.
Trade-in (if any)
Vehicle Identification Number
Year
Make
32.
Additional Trade-ins?
33.
SALES AND USE TAX COMPUTATION
(a) Sales Price($
rebate has been deducted)
$90 New Resident Tax - (Previous State)
$
(b) Less Trade-in Amount, described in Item 31 above
$5 Even Trade Tax
$(
)
(c) For Dealers/Lessors/Rental ONLY - Fair Market Value
$10 Gift Tax - Use Comptroller Form 14-317
Deduction, described in Item 31 above
$(
)
$65 Rebuilt Salvage Fee
(d) Taxable Amount (Item a minus Item b or Item c)
$
(Diesel Vehicles 1996 and Older > 14,000 lbs.)
2.5% Emissions Fee
(e) 6.25% Tax on Taxable Amount (Multiply Item d by .0625)
$
(Diesel Vehicles 1997 and Newer > 14,000 lbs.)
1% Emissions Fee
5% or
10%
(f) Late Tax Payment Penalty
$
Exemption claimed under the Motor Vehicle Sales and Use Tax Law because:
(g) Tax Paid to
(STATE)
$
(h) AMOUNT OF TAX AND PENALTY DUE
$28 or $33 Application Fee for Texas Title
$
(Item e plus Item f minus Item g)
(Contact your county tax assessor-collector for the correct fee.)
I Hereby Certify That All Statements In This Document Are True And Correct To The Best Of My Knowledge And Belief.
34.
Signature of Seller, Donor, or Trader
Printed Name (Same as Signature)
Date
35.
Signature of Additional Seller(s), Donor(s), or Trader(s)
Printed Name(s) (Same as Signature(s))
Date
36.
Signature of Applicant/Owner
Printed Name (Same as Signature)
Date
37.
Signature of Additional Owner(s)
Printed Name(s) (Same as Signature(s))
Date
WARNING: Transportation Code, § 501.155, provides that falsifying information on title transfer documents is a third-degree felony offense.
Form 130-U (Rev 07/2015)
Online Form at
Page 1 of 2
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