Dmv Lien Satisfied/title Holder Release
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1A Public Service Agency
LIEN SATISFIED/TITLE HOLDER RELEASE
Note: If this release accompanies an Application for Duplicate California Title, this form must be notarized
VEHICLE/VESSEL INFORMATION:
LICENSE PLATE/CF NUMBER
VEHICLE/VESSEL IDENTIFICATION NUMBER
MAKE/BUILDER
REGISTERED OWNER INFORMATION: Please print name as it appears on the Title/Registration or Contract.
LAST NAME
FIRST NAME
MIDDLE NAME
TITLE HOLDER INFORMATION:
This is to certify that the lien in the name of the Registered Owner shown above, against the described vehicle/vessel has been fully satisfied and has not
been assigned to any other party
NAME OF BANK, FINANCE COMPANY, OR INDIVIDUAL(S)
BUSINESS OR RESIDENCE ADDRESS
APT./SPACE/STE. NO.
CITY
STATE
ZIP
SIGNATURE OF AGENT OR INDIVIDUAL
PRINTED NAME
DATE
DAYTIME TELEPHONE NUMBER
X
NOTARY USE ONLY:
S
tate of California
)
County of _______________________________________ )
On_________________________ before me, ________________________________
Personally appeared ____________________________________________________
personally known to me (or proved to me on the basis of satisfactory evidence) to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their authorized capacity(ies), and that
by his/her/their signature(s) on the instrument the person(s), or entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal
SIGNATURE
(SEAL)
REG 166 (REV. 9/97) WWW
CUT ON LINE AND KEEP THIS PART FOR YOUR RECORDS
A Public Service Agency
LIEN SATISFIED/TITLE HOLDER RELEASE
Note: If this release accompanies an Application for Duplicate California Title, this form must be notarized
VEHICLE/VESSEL INFORMATION:
LICENSE PLATE/CF NUMBER
VEHICLE/VESSEL IDENTIFICATION NUMBER
MAKE/BUILDER
REGISTERED OWNER INFORMATION: Please print name as it appears on the Title/Registration or Contract.
LAST NAME
FIRST NAME
MIDDLE NAME
TITLE HOLDER INFORMATION:
This is to certify that the lien in the name of the Registered Owner shown above, against the described vehicle/vessel has been fully satisfied and has not
been assigned to any other party
NAME OF BANK, FINANCE COMPANY, OR INDIVIDUAL(S)
BUSINESS OR RESIDENCE ADDRESS
APT./SPACE/STE. NO.
CITY
STATE
ZIP
SIGNATURE OF AGENT OR INDIVIDUAL
PRINTED NAME
DATE
DAYTIME TELEPHONE NUMBER
X
NOTARY USE ONLY:
S
tate of California
)
County of _______________________________________ )
On_________________________ before me, ________________________________
Personally appeared ____________________________________________________
personally known to me (or proved to me on the basis of satisfactory evidence) to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their authorized capacity(ies), and that
by his/her/their signature(s) on the instrument the person(s), or entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal
SIGNATURE
(SEAL)
REG 166 (REV. 9/97) WWW
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Form Reg-166 - Lien Satisfied/legal Owner/title Holder Release - State Of California Department Of Motor Vehicles
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Sd Eform-2222 V1 - Electronic Lien And Title Nonparticipating Lender Request For Paper Title
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Parent category: Legal