Form Vr-450 - Affidavit Of Ownership Form - Moped, Motor Scooter & Off Road Vehicle

Download a blank fillable Form Vr-450 - Affidavit Of Ownership Form - Moped, Motor Scooter & Off Road Vehicle in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Vr-450 - Affidavit Of Ownership Form - Moped, Motor Scooter & Off Road Vehicle with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Motor Vehicle Administration

VR-450 (10-12)

6601 Ritchie Highway, N.E.

Glen Burnie, Maryland 21062

Affidavit of Ownership – Moped, Motor Scooter & Off Road Vehicle

Purpose:

Use this form to certify ownership and apply for title and required decal of an off road vehicle, ATV, snowmobile,

moped or motor scooter when the certificate of title or manufacturer’s certificate of origin is unavailable.

Instructions: Complete this form in its entirety. All forms and applicable fees shall be submitted electronically to the Motor Vehicle

Administration via an ERT participant or online at For a listing of ERT participants, please

visit our website at The decal will be mailed to you and should be displayed on the rear of

the vehicle in a visible position.

OWNER INFORMATION

OWNER NAME (PRINT)

CO-OWNER NAME (PRINT)

OWNER’S SOUNDEX

DATE OF BIRTH

CO-OWNER’S SOUNDEX

DATE OF BIRTH

STREET ADDRESS

CITY

STATE

ZIP CODE

VEHICLE INFORMATION

Motor Scooter

TYPE OF VEHICLE:

Off Road Vehicle

ATV

Snowmobile

Moped

YEAR

MAKE

MODEL

BODY STYLE

COLOR

VEHICLE IDENTIFICATION NUMBER (VIN)

DATE OF PURCHASE ________________________________

PURCHASE PRICE ________________________________

LIEN INFORMATION

If this vehicle is subject to any liens or encumbrances, complete the following section(s). LIEN FILING FEE $20 for each lien filed. IF NOT SUBJECT TO A LIEN, WRITE

THE WORD “NONE” BELOW.

NAME OF SECURED PARTY

STREET ADDRESS OF SECURED PARTY

CITY

STATE

ZIP CODE

KIND OF LIEN (DESCRIBE)

DATE OF LIEN

AMOUNT OF LIEN

ACCOUNT NUMBER

CERTIFICATION

I/We certify under penalty of law that the operator(s) of the mopeds and motor scooters will carry evidence of required insurance and wear

protective headgear. Operators must also wear protective eye gear unless moped or motor scooter is equipped with a windscreen.

Knowingly making a false statement on this form is punishable by a fine of $1,000 and 10 years imprisonment.

I solemnly affirm under penalties of perjury and upon personal knowledge the contents of the foregoing document are true and correct to the best of

my knowledge and belief.

I/We further certify that should any legal action arise as a result of issuing a Certificate of Title my/our application for same, herein described, I/we

hereby bind ourselves, our heirs, assigns and personal representatives to indemnify and save harmless the Maryland Motor Vehicle Administration for

any loss or damage which may be asserted against or which may be sustained as a results thereof.

Any willful misinformation provided with fraudulent intent may be prosecuted under Maryland law.

OWNER’S SIGNATURE

OWNER’S PRINTED NAME

DATE

CO-OWNER’S SIGNATURE

CO-OWNER’S PRINTED NAME

DATE

Decal Number (MVA Use Only) _____________________

For more information, please call: 410-768-7000 (to speak with a customer service representative).

TTY for the hearing impaired: 1-800-492-4575. Visit our website at: