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SD EForm - 0863
V4
FEE: $10.00
STATE OF SOUTH DAKOTA
MV-010 (12/03)
INSTRUCTIONS
APPLICATION FOR A DUPLICATE CERTIFICATE OF TITLE
Date of Application________________________
1. This form must be signed in front of a notary public and
Odometer Reading is______________________ /which is actual vehicle mileage
submitted with the notary public’s seal affixed.
unless one of the following is checked. Stated Mileage:
Exceeds odometer's mechanical limits
Is not actual mileage WARNING-
2. An odometer reading is required on vehicles under 10 years
ODOMETER DISCREPANCY
old and vehicles with a gross vehicle weight rating of 16,000
________________________________ _______________________________
pounds or less.
Vehicle Title or Boat Number
Serial or Identification Number
______________ _____________ ______________ _________ __________
3. If a lien is indicated on the title record, a lien release must
Make
Model or Length
Body Type
Year
Weight
be submitted with the application or the lienholder must
________________________________________________________________
sign the application in the designated area.
Owner/Owner(s) name as it appears on title
________________________________________________________________
Owner/Owners Current Mailing Address
4. If the duplicate title is to be mailed to someone other than
the owner, the mailing instructions must be indicated on the
__________________________________ _________ ________ __________
City
State
Zip Code
County
form.
LIENHOLDER INFORMATION
I certify that there
ARE
ARE NOT any outstanding liens, mortgages or
5. If someone authorized to sign for an owner through a power
other encumbrances on the described vehicle or boat. If there ARE, complete the
of attorney is signing this form, a copy of the power of
section below:
attorney form is required. The original power of attorney
form should be retained in the event it is needed for
_____________________________________________ __________________________
assigning the duplicate title.
Amount Code
Held By
Address
_____________________________________________ __________________________
Amount Code
Held By
Address
6. Once this form is completed, along with a $10 fee, it can be
APPROVAL OF LIENHOLDER: The above lien is still effective and is to be listed
returned to your County Treasurer’s Office or it can be
on the duplicate title when issued.
mailed to:
________________________________________________________________________
Lienholder Signature
Name of Lienholder
ATTN: Duplicate Title Section
____________________________ ___________ ___________ ___________
Division of Motor Vehicles
Lienholder Address
City
State
Zip Code
445 East Capitol Avenue
Pierre, SD 57501-3185
APPLICANT CERTIFICATION
As the applicant, I certify that the information shown above is true and correct to
the best of my knowledge and that the Certificate of Title originally issued to me
has been: (describe)
________________________________________________________________
(Lost, Stolen, Destroyed, etc.)
and that I have not transferred the vehicle or boat described above to another owner,
or that if it has been transferred, that I am applying for a duplicate title on behalf of the
new owner.
________________________________________________________________
Signature(s) of Applicant/Owner(s)
Subscribed and sworn to before me this ___________ day of__________, 20___
My commission expires _____________ _______________________________
Notary Public
This application is INVALID unless properly notarized.
1.
2.
PRINT FOR MAILING
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