Form Tr-42 - Request And Consent For Kansas Title To Be Issued With Lien And Mailed Out Of State

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REQUEST AND CONSENT
FOR KANSAS TITLE TO BE ISSUED
DEPARTMENT OF REVENUE
DIVISION OF VEHICLES
WITH LIEN & MAILED OUT OF STATE
C
O
O
ENTRAL
FFICE
PERATIONS
INSTRUCTIONS
The Kansas certificate of title will be issued when both the lien holder and titling jurisdiction complete this form and it is received by
the Kansas Titles and Registrations Bureau.
The lien holder listed on the Kansas title record, and the new titling jurisdiction must complete their portion of this form*.
The lien holder must consent to a Kansas certificate of title being issued with their lien listed, and surrendered directly to the new titling
jurisdiction. The consent must be notarized. Title will not be mailed to the lien holder or owner.
The new titling jurisdiction must request the Kansas certificate of title be issued and mailed to their office for title and registration purposes.
Mail or fax the completed form to the Kansas Titles and Registrations Bureau. Please
, just one or the other. Fax only once.
DO NOT FAX AND MAIL
Fax to: 785-296-2383
OR
Mail to: Kansas Department of Revenue; Division of Vehicles,
Attn. Print Title w/ Lien
915 SW Harrison; Topeka, KS 66626-0001
Office (785) 296-3621
*
The same information may be provided on the lien holder and titling jurisdiction’s letterhead, however, the information must be received in
Kansas Titles and Registration at the same time.
NOTE: If the application for Kansas certificate of title has not been completed by the owner, the title cannot be issued until it
has been completed. The title cannot be mailed to the lien holder or owner.
VEHICLE INFORMATION
Please Type or Print
VIN
Make
Year
Kansas License Plate No., if available
OWNER’s Name(s)
Email
New/Current Address
City
State
ZIP
Telephone
Owner’s new address MUST be outside the State of Kansas, in the state the vehicle is going to be titled and registered. TITLE WILL NOT BE MAILED TO THIS ADDRESS.
LIEN HOLDER’s Name
, of:
Address
City
State
ZIP
By the signature affixed, the lien holder listed herein consents and
approves the Kansas Titles and Registrations Bureau to issue a Kansas
Sworn and signed before me this
day of
, 20____
_
_____
_____________
certificate of title showing this lien and mail the Kansas title directly to
Notary Public:
the new titling jurisdiction requesting same.
Commission Expires:
Authorized
Agent:
MUST BE NOTARIZED. Place Notary Seal Here.
(DMV) for the jurisdiction of
requests that the State
VEHICLE TITLING AGENCY
of Kansas issue a certificate of title in the name of the owner(s) listed herein with the lien for the above lien holder and mail same
directly to the DMV office shown below:
Name of
DMV Office:
Attn.:
Address
City
State
ZIP
Authorized
Name Hand
Associate:
Printed:
Date:
TR-42 (9/13)

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