Form 2223 - South Dakota Order To Cancel Lien For Nonparticipating Elt Lender

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SD EForm - 2223
V2
HELP
Complete and use the button at the end to print for mailing.
SD ORDER TO CANCEL LIEN FOR NONPARTICIPATING ELT LENDER
County Treasurer:
You are hereby authorized and directed upon presentation of this Order to
Cancel Lien, which lien was noted on:
SD Title Number _________________________ Year ___________Make ____________________
Serial No./VIN _______________________________________________________________________
in the name of (registered owner’s name):
_____________________________________________________________________________________
in our favor on (date): ___________________________ , to note such cancellation of lien
on your records.
Name of individual/entity and address where printed South Dakota certificate
of title is to be mailed. If nothing indicated, title will be mailed to the owner at
the address indicated on the customer’s record on file with DMV.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Date: ___________ Lender: ___________________________________________________________
Authorized Representative’s Signature:_______________________________________________
CLEAR FORM
PRINT FOR MAILING
SD Department of Revenue
Division of Motor Vehicles
MV-011
Revised 11/12

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