Application For Certificate Of Ownership
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1Purchase Price $ ______________________
NJ Motor Vehicle Commission
Special Services Titles
Sales/Use Tax $ ______________________
P.O. Box 017
Trenton, NJ 08666-0017
Ex. Code__________ Initials_____________
APPLICATION FOR CERTIFICATE OF OWNERSHIP
PLEASE DESCRIBE THE VEHICLE ACCURATELY
MAKE OF VEHICLE (PRINT)
MODEL
YEAR
COLOR
BODY TYPE
COMPLETE VEHICLE IDENTIFICATION NUMBER (NOT THE MOTOR NUMBER)
NO. OF AXLES
I
ODOMETER READING
TENTHS
PLEASE
C H E C K
Does your vehicle now have a lien? (Is your vehicle financed?)
Yes
No
"YES" OR " N O "
If you checked "yes" PRINT name and address of bank or finance company below. If you checked "No", print 'NONE" in the box below.
NAME OF BANK OR FINANCE COMPANY (LIENHOLDER), IF NO LIEN PRINT "NONE"
LIENHOLDER CORPCODE
STREET ADDRESS OF LIENHOLDER
NAME AND ADDRESS OF OWNER AND CO-OWNER BELOW
NAME
N.J. DRIVER LICENSE NO. (IF BUSINESS-CORPCODE)
SEX
DATE OF BIRTH
EYE COLOR
STREET
CITY, STATE, ZIP CODE
NAME
N.J. DRIVER LICENSE NO. (IF BUSINESS-CORPCODE)
EYE COLOR
SEX
DATE OF BIRTH
STREET
CITY, STATE, ZIP CODE
STATEMENT OF APPLICANT(S): The undersigned hereby certifies all of the above to be true and correct and that the identification
number shown on this form has been compared to the identification number on the motor vehicle and further certifies that they agree
in every particular.
SIGN
SIGN
HERE
HERE
x
x
OWNER
DATE
CO-OWNER (if any)
DATE
SIGN
SIGN
HERE
HERE
x
x
CO-OWNER (if any)
DATE
CO-OWNER (if any)
DATE
OS/SS-7 (R2/09)
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Parent category: Business