Form Mv-217 - Application For Certificate Of Title After Default By Owner - Pennsylvania Department Of Transportation Page 2

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NOTE: THIS IS ONLY A SAMPLE. A certified copy of the original is required under Option 3 on
the front of this application.
SAMPLE COURT ORDER
AND NOW, this
day of
, 20
, after reasonable notice and an
opportunity for hearing having been provided to all interested parties, the Court hereby
awards ownership of one [year], [make], [model], bearing vehicle identification number
_________________________________________ to [name of applicant], and the
right, title and interest of any other person to said vehicle is hereby extinguished. The
Department of Transportation may accept this order as evidence of ownership in lieu of
a certificate of title. The Petitioner shall submit the appropriate forms, taxes and fees
and comply with any other procedures of the Department of Transportation in order to
receive the appropriate certificate of title for said vehicle.
BY THE COURT:
_______________________________________________
, Judge

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