Form Tr-65 - Kansas Resident/business Out Of State Vin Verification

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KANSAS
KANSAS RESIDENT/BUSINESS
DEPARTMENT OF REVENUE
DIVISION OF VEHICLES
OUT OF STATE VIN VERIFICATION
Reverse side (page 2) has Instructions and Additional Information
Part I – O
D
(To be completed by vehicle owner)
WNER
ECLARATION
I, the under signed, certify that I have a title issued by another state or country for vehicle described below which has been assigned to me by the
owner of the vehicle and the vehicle is located outside of Kansas due to the qualifying reason checked below:
(Check one and explain)
Kansas resident on active military duty stationed out-of-state,
Kansas resident attending an out-of-state college, university or school,
Application for Kansas apportioned registration,
Kansas resident or business temporarily* out of Kansas. Date the vehicle will be returned to Kansas:
* Reason:
Explanation:
I further certify that the foregoing is true and correct. I understand that by submitting this form with an application for Kansas title and registration I
agree to any and all requirements indicated on this form and any additional requirements as determined by the Kansas Division of Vehicles and/or
the Kansas Highway Patrol. All decisions by the Division and/or the Patrol are final.
Owner’s printed name
Owner’s signature
Date
Owner’s Out of State Address
City
State
ZIP
Owner’s Kansas Address
City
State
ZIP
Part II – VIN V
(Must be completed by Law Enforcement Officer)
Must be Typed or Completed in Ink.
ERIFICATION
Vehicle
Identification
Number
Year
Make
Model
Body Style
Color
Title Issued by the State of
Title Number
Odometer Reading
(No Tenths)
Title branded (labeled)?
No
Yes, as:
Salvage
Rebuilt/Restored Salvage
Other:
SUPPORTING DOCUMENTS: (Check one)
Agrees with VIN
Disagrees with VIN
No VIN on documents
See Remarks
Remarks:
I certify that I am a law enforcement officer and I have physically examined the vehicle and title described herein and the
information matches and is true and correct to the best of my knowledge. I have checked the VIN through the FEDERAL
STOLEN VEHICLE FILE (NCIC) and no record was found.
Name of Officer (Print)
Title
Badge/ID Number
Officer Signature
Date
Law Enforcement
Agency
Telephone (
)
email
Agency’s Address
City
State
ZIP
ALTERATIONS OR ERASURES WILL VOID THIS FORM
65 (Rev. 06/07)
TR-
Previous versions of this form are subject to requirements listed herein.

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