Form Vp-147 - Lien Sale Affidavit - Lien Claimant'S Certification
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2555 Wright Way
Carson City, NV 89711-0700
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas area (702) 486-4DMV (4368)
Rural Nevada or Out of State (877) 368-7828
LIEN SALE AFFIDAVIT
Type of Ownership Document Requested
(Please select one title type)
Title
Salvage Title
Please Print or Type
I, ___________________________________ on behalf of _________________________________________________,
Full Legal Name of Business Representative
Business Name
Nevada DMV Business License or Registration Number ___________________________________________________,
Business Address __________________________________________________________________________________
Address
City
State
Zip Code
Certify that on the __________ day of _________ 20______, one ____________________________________________
Name of who authorized the service from the business above
left with him/her the vehicle described as follows:
Vehicle Identification Number
Year _________ Make ___________________ Model __________________ Body Type _____________ Cylinders ____
Registered Owner(s) ________________________________________________________________________________
First
Middle
Last
Physical Address __________________________________________________________________________________
Address
City
State
Zip Code
Legal Owner ______________________________________________________________________________________
Address __________________________________________________________________________________________
Address
City
State
Zip Code
The charges assessed are for (check all appropriate boxes):
Towing
Storage
Repair
Accessories or Supplies, totaling the sum of $__________________
and was not paid after due notice and demand was given and made pursuant to the provisions of NRS 108.270 through
108.360. Therefore on the ______ day of ____________ 20________, the vehicle was sold pursuant to the provision of
said law, at public auction for the sum of $__________________, Nevada Sales Tax Collected $__________________,
Nevada title and title processing fee $________________, therefore, the Total Purchase Price of $__________________.
(If purchaser is a licensed wrecker in the state of Nevada, do not collect title fee. Provide the lien sale packet to the
licensed wrecker.)
and
Purchaser’s Full Legal Name ___________________________________________________________________
or
First
Middle
Last
Nevada Driver’s License, ID Card Number, Date of Birth, or FEIN for businesses ________________________________
(If no Nevada Driver’s License or ID Card Number, write “NONE”.)
Purchaser’s Full Legal Name _________________________________________________________________________
First
Middle
Last
Nevada Driver’s License, ID Card Number, Date of Birth, or FEIN for businesses _______________________________
(If no Nevada Driver’s License or ID Card Number, write “NONE”.)
Physical Address __________________________________________________________________________________
Address
City
State
Zip Code
Mailing Address ___________________________________________________________________________________
Address
City
State
Zip Code
Lienholder Name __________________________________________________________________________________
(if no lienholder, write “NONE”.)
NV ELT #
Address __________________________________________________________________________________________
Address
City
State
Zip Code
VP-147 (Revision Date September 2015)
ALTERATION OR ERASURE VOIDS THIS AFFIDAVIT
(Page 1 of 2)
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Parent category: Legal