Form Mv-103 - Affidavit Of Responsibility printable pdf download

South Carolina Department of Motor Vehicles

MV-103

(Rev. 5/09)

AFFIDAVIT OF RESPONSIBILITY

The legend/brand “Undisclosed Lien” will be added to the title whenever this form is used. This is in

accordance with SC DMV Policy TI-006 Title and Registration Issuance as well as SC Code of Law §56-19-300.

SC DMV Policy TI-006 Title and Registration Issuance states that when a SC title is issued that does not have a

previous title to support it, the certificate of title shall contain the legend/brand “undisclosed lien” and must remain on

the title for 120 days. At the end of the 120 days, the brand can be removed if the customer requests a new title and

pays the appropriate fees.

SECTION 56-19-300. Contents of certificate for vehicle last registered where lienholders not named on certificate.

A distinctive certificate of title shall be issued for a vehicle last previously registered in another state or country, the

laws of which do not require that lienholders be named on a certificate of title to perfect their security interests. The

certificate shall contain the legend, “THIS VEHICLE MAY BE SUBJECT TO AN UNDISCLOSED LIEN,” and may

contain any other information the Department of Motor Vehicles prescribes.

Acceptance of this form does not waive any other requirements for documentation by the

Department of Motor Vehicles.

I, ___________________________________________________________________________________,

_____________________________________________________________________________________

Street

City

State

Zip Code

am the buyer/owner of the following motor vehicle: MAKE: ____________ MODEL: ______________

YEAR: ________ VEHICLE IDENTIFICATION NUMBER: __________________________________

I/we have exhausted all remedies in an attempt to obtain the previously issued title for the above described

motor vehicle.

To my knowledge, there are no outstanding liens on the vehicle except those listed on the Department of

Motor Vehicle’s application for certification of title/registration (Form 400).

By my signature below, I accept full responsibility if any other liens or other encumbrances exist against

the above described vehicle.

_______________________________________

___________________________________________

Signature of Applicant

Date

Signature of Applicant

Date

________________________________________

___________________________________________

Hand Printed Name of Applicant

Job Title

Form Mv-103 - Affidavit Of Responsibility