Sd Eform-0863 V7 - Application For A Duplicate Certificate Of Title
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SD EForm - 0863 V7
HELP
Fee:
$10.00
STATE OF SOUTH DAKOTA
MV-010 (2/12)
APPLICATION FOR A DUPLICATE CERTIFICATE OF TITLE
Date
of Application
_
Odometer reading is
miles
kilometers,
which is
actual vehicle
mileage
unless one of
the following
statements
is
checked.
Stated mileage exceeds odometer's mechanical
limits,
or
Stated mileage is not
the
actual mileage. WARNING-ODOMETER
DISCREPANCY
Vehicle or
Boat Title Number
Serial
Number
(VIN or
HIN)
Make
Body
Type
Weight
Model or
Length
Year
Owner/Owner's
name
as
it
appears on
title
Owner/Owner's Current Mailing Address
City
State
Zip Code
Special Mailing
Name
and Address
City
State
Zip Code
Lienholder Information
By signing, the lienholder is granting approval for the owner to obtain a duplicate title. The lien will appear on the duplicate title, unless
a separate lien release accompanies the application.
Lienholder Name
Lienholder Address
Lienholder Signature
1. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2
.
APPLICANT CERTIFICATION
As the
applicant,
I
certify that the
information
shown above
is
true and correct to the best of
my
knowledge and that the Certificate
of
Title
originally issued
to
me
has
been:
(Circle One) Lost, Stolen, Destroyed, Mutilated, Illegible, Never Received ,
and that I
have
not
transferred the vehicle or boat described above to another
owner,
or
if it has
been
transferred,
that I
am
applying
for
a duplicate title on behalf of the
new
owner.
Subscribed and sworn before me this
day of____________________________20________________________
My commission expires _____________________________________________________________________________________
_______
Notary Public Signature and Seal
This
application
is INVALID unless
properly
notarized.
INSTRUCTIONS
1. This form must be signed in front of a notary public and submitted with the notary public's seal affixed.
2. An odometer reading is required on vehicles 9 years old or
newer,
and on vehicles with a gross vehicle
weight rating of 16,000 pounds or less.
3.
If a lien is
indicated
on the title record, a lien release must be submitted with the application or the
lienholder must sign
the
application in the designated area.
4. If the duplicate title is to be mailed to someone other than the owner, the mailing instructions must be
indicated on the form.
5. If someone authorized to
sign
for an owner through a power of attorney is
signing
this form, a copy of
the power of attorney form
is required.
The original power of attorney form should be
retained in
the
event it is needed for assigning the duplicate title.
6. Once this form
is
completed along with a $10 fee, it can be
returned
to your County Treasurer's Office or
it can be mailed to:Duplicate Title Section, Division
of Motor
Vehicles,
445
E. Capitol
Avenue,
Pierre,
SD
57501-3185.
PRINT FOR MAILING
CLEAR FORM
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