Form Elt-3 - Application For Title/lien Escrow Account

APPLICATION FOR TITLE/LIEN ESCROW ACCOUNT

Revenue Accounting

PO Box 2409, ESP

Albany, NY 12228

To apply for an Escrow Account a $200.00 minimum balance, or an amount sufficient to cover lien filings for a two-month

period, is required.

Please provide the information below, and return this letter with your check made payable to Commissioner of Motor

Vehicles to the above address. Once processed, a confirmation will be mailed to the address you provide.

Lienholder Filing Code Number (one code):__________________________________________________

Lien Institution Full Name

Street Address

City

State

Zip

Contact Person/Title

Telephone Number (Area Code)

(

)

Contact email

dmv.ny.gov

ELT-3 (1/17)

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Parent category: Legal