Form Mvr 40-12-23 - Petition For Refund Of Registration Fees Erroneously Or Excessively Paid For Motor Vehicle License

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MVR 40-12-23
9/14
A
D
r
lAbAmA
epArtment of
evenue
m
v
D
otor
ehicle
ivision
p.o. box 327630 • montgomery, Al 36132-7630 • (334) 242-9006
petition for refund of registration fees
erroneously or excessively paid for motor vehicle license
THIS FORM IS TO BE FILED WITH YOUR LICENSE PLATE ISSUING OFFICIAL
Instructions:
A. items one (1) thru twelve (12) below must be completed.
b. if applicable, you must submit with the petition the license plate (and/or decal) for which you are requesting the refund, and a copy of the
motor vehicle registration tag and tax receipt or cab card.
c. in item five (5) below, you must give a detailed explanation as to why you believe you are entitled to a refund. in giving this explanation,
please give information such as duplicate tag number, dates (date vehicle was last driven while owned by petitioner), and to whom vehicle
was traded or sold. the petition will be denied if an insufficient explanation is submitted.
ExamplEs:
a. two decals were bought for the same vehicle by the same owner. one was purchased on february 3, ______ (decal
no. 22-1245) and the second was purchased on february 18, ______ (decal no. 22-7875).
b. in error, i purchased a tag march 15, ______ for a vehicle which had been sold on January 5, ______ (proof of sale
of vehicle should be submitted).
D. the petition must be applied for in the name of the person in whose name the tag receipt or cab card is listed.
e. if the vehicle has been sold, please include a copy of the bill of sale showing the date sold and to whom it was sold.
f. if the vehicle was wrecked and totaled, please send a copy of the accident report or insurance report showing the date wrecked or totaled.
G. if the vehicle has not been in operation, please include an affidavit of non-use giving the last date the vehicle was operated on the roads
of Alabama.
As provided by Sections 40-12-23, 40-12-24 and 40-2A-7, Code of Alabama 1975, you are hereby requested to refund the amount erro-
neously or excessively paid as evidenced by:
1. License Plate No. ____________________________ (plate must be surrendered if applicable).
2. Decal No. __________________________________ (decal(s) must be surrendered if applicable).
3. Vehicle Identification Number (VIN)*: ________________________________________________________________
4. County of Registration: _________________________________________________________.
The facts on which this refund is sought and the reasons why the payment of said amount was erroneously or excessive, are as follows:
5. ______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
I attest that the above and foregoing Statement of Facts are true and correct to the best of my knowledge and I understand that this state-
ment is made under penalties of perjury.
6. Sworn and subscribed before me
7. ____________________________________________________
PETITIONER(S)
this the _____ day of _________________________, _______.
8. ____________________________________________________
YEAR
PETITIONER(S) NAME(S) TYPED OR PRINTED
___________________________________________________
9. ____________________________________________________
SIGNATURE OF NOTARY PUBLIC
ADDRESS
My commission expires: ________________________________
10. ____________________________________________________
CITY
STATE
ZIP
11. ____________________________________________________
TELEPHONE NUMBER
12. ____________________________________________________
EMAIL ADDRESS
*All VINs for 1981 and subsequent year model vehicles that conform to federal anti-theft standards are required to have 17 digits/characters.

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