Form 1062 - Affidavit For Mechanic Lien Title Page 2
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1
2Mechanic Lien Titles
In order to apply for a mechanic lien title for a motor vehicle, trailer, all-terrain, manufactured home, vessel or outboard motor, you must
submit the following:
1. A completed and signed application for Missouri Title and License, DOR-108 (for motor vehicles, trailers, all-terrain vehicles and
manufactured homes), or a completed and signed Application for Missouri Boat, Vessel, or Outboard Motor Title and Registration,
DOR-93 (for vessels or outboard motors). For type of title, record “mechanic lien.”
2. The original or a copy of the written request for labor, services, skill, materials or storage costs signed by the owner, his agent, or
at the written request of a peace officer in lieu of the owner or owner’s agent, where such owner or agent is not available to request
storage, with the maximum amount to be charged as stated.
3. A notarized affidavit from the holder of the property certifying that the owner has defaulted on payment of labor, services, skill, or
materials and that payment is 45 days past due, or that the owner has defaulted on payment, or has failed to make satisfactory
arrangements for continued storage of the chattel for 30 days since notification by mail of intent to title.
4. A statement showing the outstanding balance for all labor, services, skills, materials or storage costs accumulated up to the date of
application for title.
5. A check for $12.50 made payable to the Missouri Department of Revenue. The Missouri Department of Revenue may electronically
resubmit checks returned for insufficient or uncollected funds.
Note: All requests for mechanic lien titles will be held for the 30 day notification period as required by law.
Form-1062 (Revised 06-2013)
Mail to:
Motor Vehicle Bureau
Phone: (573) 526-3669
Visit dor.mo.gov
P.O. Box 2076
Fax: (573) 751-5209
for additional information.
Jefferson City, MO 65105-2076
E-mail: mvbmail@dor.mo.gov
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