Affidavit And Application For Obtaining A Duplicate Certificate Of Title Form
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1AFFIDAVIT AND APPLICATION FOR
OBTAINING A DUPLICATE CERTIFICATE OF TITLE
Park County Clerk
1002 Sheridan Ave Cody, WY 82414
INSTRUCTIONS
•
Download and complete this application for duplicate title.
•
All Owners must sign the application in the presence of a Notary Public.
Mail the completed application along with a $15.00 non-refundable fee to
•
Park County Clerk, 1002 Sheridan Avenue, Cody, WY 82414.
•
Duplicate title will be issued eleven (11) days from receipt of application, pursuant to Wyoming
Statute §31-2-105.
I hereby certify that Certificate of Title No.________________ of Park County, Wyoming, was issued
to me for the motor vehicle briefly described below and that to the best of my knowledge and belief the
said Certificate of Title has been m utilated, lost or destroyed, and that it is not assigned to, or in the
possession of any other person, and there are no additional liens on s aid motor vehicle other than
shown on the original Certificate of Title.
Make of Motor Vehicle: ____________________ Type: ____________________ Year: ___________
Name of Owner(s):________________________________VIN: _____________________________
I(We) hereby make application for a Duplicate Certificate of Title covering the said motor vehicle, and
authorize the same to be delivered to: Please include a self-addressed stamped envelope.
Name:___________________________________Address:________________________________
City:_________________________ State:__________ Zip:_______________ Phone#___________
I ALSO UNDERSTAND THAT ONCE A DUPLICATE TITLE IS ISSUED ON THIS REQUEST THAT
THE ORIGINAL, IF FOUND, IS INVALID AND MUST BE DESTROYED.
All parties whose names appear on the Title must sign in the presence of a Notary Public
or County Clerk.
Signature of Applicant __________________________________________________________
Signature of Applicant __________________________________________________________
_______________________________________________________ appeared before me in the
State of _________________, County of ______________________, this ________ day
of_____________________________, 20_______.
______________________________
Notary Public or County Clerk
My term/commission expires:
OFFICE USE ONLY
Sales Tax Paid________________
Date Checked in RIS________________
Lien: Yes
or
No
Initials_____________
Fee Received: _____ Check
_____ Cash ____CC
Date to be Issued _________________________
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