Form Tr-121 - Vehicle Uniform Surety Bond
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Michigan Department of State
Vehicle Uniform Surety Bond
Applicant’s First Name
Middle
Last
Date
Residence Address
City
State
Zip Code
The above applicant wishes to apply for a certificate of title or registration for the following unit:
Vehicle Title
_____________________________________________________________________________________________________
(Year and Make of Vehicle)
(Body Style)
(Vehicle Identification Number)
Watercraft Title
_____________________________________________________________________________________________________
(Year and Make of Watercraft)
(Hull Type)
(Hull Number)
Watercraft Registration
____ _________________________________________________________________________________________________
(Year and Make of Watercraft)
(Hull Type)
(Hull Number)
Snowmobile Registration
_____________________________________________________________________________________________________
(Year and Make of Snowmobile)
(
Serial Number)
Because the Michigan Department of State is not satisfied as to the ownership of this vehicle/watercraft/snowmobile, the department
requires the applicant to file this bond as a condition of issuing a Michigan title or registration pursuant to section 217(1) (d) of the
Michigan Vehicle Code, 1949 PA 300, as amended (MCL 257.217), and Sections 803 and 821 of the Natural Resources and
Environmental Protection Act as amended (324.80307 and 324.82105).
We, ________________________________, as Principal, and ____________________________________________________,
(Name of Applicant)
(Name of Authorized Surety Company)
as Surety, by this instrument firmly bind ourselves, our heirs, executors, administrators and successors, and assigns, jointly and
severally, to the Michigan Department of State, its officers and employees, for the benefit of any interested person, in the amount of
$_________________ Dollars. (This amount being equal to twice the value of the vehicle, watercraft, or snowmobile.)
The Principal shall indemnify and hold harmless the Secretary of State, every employee of the Michigan Department of State, any
prior owner, any subsequent purchaser of the vehicle, watercraft or snowmobile described above, and their successors in interest,
against any expense, loss or damage, including reasonable attorney fees, by reason of the issuance of a Michigan certificate of title or
registration to the Principal for the unit described above, or an account of any defect in the right, title or interest of the Principal in the
vehicle, watercraft or snowmobile.
This bond is subject to the following provisions:
1. Any interested party may bring an action in the party’s own name to recover on this bond any damages sustained by the party for
any breach of the conditions for which the bond is deposited, and may recover costs and reasonable attorney fees.
2. The Surety’s aggregate liability to all interested persons shall not exceed the amount set forth above.
3. If the vehicle, watercraft or snowmobile is no longer titled or registered in this state and the currently valid title or registration is
surrendered, the latest the bond will be in effect is at the end of three years from the time it was issued, unless the department
receives notification of pending action to recover on this bond.
The Principal and Surety have executed this bond on ________________________________, 20________.
APPLICANT – PRINCIPAL
SURETY
X
X
(Signature of Principal or Authorized Agent of Principal)
(Signature of Authorized Agent of Surety Company)
____________________________________________ _
_______________________________________________
(Print or Type Name)
(Print or Type Name)
TR-121 (04/2013)
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