Form Mvt 5-9 - Supporting Document To A Mail Order Application For Certificate Of Title
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1
2A
D
R
LABAMA
EPARTMENT OF
EVENUE
M
V
D
OTOR
EHICLE
IVISION
T
S
ITLE
ECTION
P. O. Box 327640 • Montgomery, AL 36132-7640
Supporting Document to a
MVT 5-9
6/04
Mail Order Application For Certificate of Title
THIS FORM MAY BE DUPLICATED OR ADDITIONAL COPIES MAY BE OBTAINED FROM THE DEPARTMENT WEB SITE AT
Part I
POWER OF ATTORNEY
Date __________________________________________________
I hereby appoint _________________________________________________ of _________________________________, Alabama as my
COUNTY OFFICIAL
COUNTY
attorney-in-fact, to apply for a certificate of title and registration for license plates to the motor vehicle described as: ____________
MAKE
____________
_________________________
____________________________
_________________________________________
YEAR
TYPE
MODEL
VEHICLE IDENTIFICATION NUMBER
_____________________________________
___________________________________________________
_____________________
LICENSE PLATE NUMBER
STATE
YEAR
and for said purpose to sign my name and do all things necessary to this appointment.
_____________________________________________________
_____________________________________________________
SIGNATURE OF OWNER
SIGNATURE OF ADDITIONAL OWNER(S)
Part II
CERTIFICATION OF LEGAL RESIDENT
I, ________________________________________________________, certify that I am a legal resident of the State of Alabama and
NAME OF APPLICANT
that my legal Alabama resident address is:
______________________________________________________ or _______________________________________________________
STREET ADDRESS
POST OFFICE BOX
Alabama
__________________________________, __________________________________, ______________________ _____________________
CITY
COUNTY
STATE
ZIP CODE
and shall be shown as my legal resident address by my attorney-in-fact on an Application For Certificate of Title (form MVT 5-1).
I certify under penalty of perjury that the above information is true and correct.
____________________________________________________
FOR DESIGNATED AGENT USE ONLY
SIGNATURE OF ALABAMA RESIDENT
____________________________________________________
NOTE: If Resident Address is different from Mailing
PRESENT MAILING ADDRESS
Address, indicate in space provided on Application For
____________________________________________________
Title (form MVT 5-1).
CITY, COUNTY, STATE, ZIP CODE
____________________________________________________
DATE OF SIGNATURE
NOTE: Act number 765, passed by Regular Session, 1973 Alabama Legislature, shall be cited as “Alabama Uniform Certificate of
Title and Antitheft Act.” Section 44, Sub-section (d) of the above Act reads as follows: “A person is guilty of a felony who, with
fraudulent intent uses a false or fictitious name or address, or makes a material false statement, or fails to disclose a security
interest, or conceals any other material fact, in an application for a certificate of title.”
I, the undersigned, have read and understand the above information.
____________________________________________________
SIGNATURE OF ALABAMA RESIDENT
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