Form Tr-10 - Certification Of Repossession - Michigan Department Of State
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1
2Michigan Department of State
Clear Form
CERTIFICATION OF REPOSSESSION
See Instructions on Reverse Side
(Print Plainly or Use Printer)
This certification is required when filing a title application for a repossessed vehicle, titled ORV, or titled watercraft, or a registration
when repossessing a snowmobile, as provided by state law or under the provisions of the Uniform Commercial Code.
I, ____________________________________________________, am the _______________________________________________
(Printed Name)
(Official Capacity)
of the ________________________________________ at ____________________________________________________________
(Company Name)
(Company Address, City, State, Zip)
and have in possession the following vehicle, ORV, watercraft, or snowmobile:
Year
Make
Vehicle Identification Number, Hull Identification Number, or Snowmobile Serial Number
Body Style
License Plate or Registration Number
Repossessed From (name)
Street Address
City
State
Zip Code
Repossessed On (Date)
*
(1)
by reason of default of a:
_____________________________________________________________________________________________________________________________
*
(2)
The repossession notice was served on the following persons and lienholders: (list names and addresses)
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
*
______________________
__________________________________________
(3)
Notice (check below) was served on
by
(mm/dd/yyyy)
*
(4)
a) a notice that the above item would be retained in full satisfaction of the obligation.
CHECK
PROPER
_________________
b) a notice that the above item would be sold at private sale or otherwise disposed of after
at:
ITEM
(mm/dd/yyyy)
c) a notice that the above item would be sold at public sale on ___________________ at:
(mm/dd/yyyy)
________________________________________________________________________________________________
[Enter place of sale if (b) or (c) is marked above]
If the vehicle, watercraft, or ORV Certificate of Title or the snowmobile registration is not enclosed, provide the reason:
*
(5)
_____________________________________________________________________________________________
Federal law and section 233a of the Michigan Vehicle Code require that you state the mileage when transferring ownership of
a motor vehicle. Failure to complete or providing a false statement may result in civil liability, fine, and/or imprisonment.
I state the odometer mileage is:
and certify that to the best of my knowledge the odometer
reading is:
(No Tenths)
actual mileage
not actual mileage–
exceeds mechanical limits of odometer
WARNING–ODOMETER DISCREPANCY
X
Signature
Date
I have read and understand the certification on the second page of this form
TR-10 (5/10)
Authority Granted Under Act 300, P.A. of 1949, as Amended
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