Form 130-U - Application For Texas Title

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APPLICATION FOR TEXAS TITLE
TYPE OR PRINT NEATLY IN INK
TAX OFFICE USE ONLY
Standard Presumptive Value
SPV $
Tax Collector:
County:
Date:
Transaction Number:
Appraisal Value $
1. Vehicle Identification Number
2. Year
3. Make
4. Body Style
5. Model
6.
7. Empty Weight (lbs.)
8. Carrying Capacity (lbs.)
9. Plate No.
10. Vehicle Unit No.
11. Major Vehicle Color
12. Minor Vehicle Color (two colored)
13. Applicant Type
Individual
Business
Government
Trust
Non-Profit
Business, Government, Trusts and Non-Profits, use the Business Name line below.
Owner's County Name
14. Applicant's/Owner's Legal Name 1/Business Name
First
Middle
Last
Suffix
Mailing Address
City
State
Zip
14a. Applicant/Owner 1
Photo ID Number
ID Type
(Name of State or Territory)
U.S. Driver's License
U.S. State Identification
Texas
Other
(Name of Foreign Country)
U.S. Passport
Foreign Passport
U.S. Military ID
NATO ID
Other Military Status of Forces Photo ID
U.S. Department of Homeland Security ID
U.S. Citizenship & Immigration Services ID
U.S. Department of State ID
14b. Applicant's/Owner's Legal Name 2
First
Middle
Last
Suffix
Mailing Address
City
State
Zip
14c. Registrant's Name (Renewal Notice Recipient)/Business Name
First
Middle
Last
Suffix
Mailing Address
City
State
Zip
14d. Vehicle Physical Location Address
City
State
Zip
15. Previous Owner's Legal Name/Business Name
15a. GDN -Dealer Use Only
First
Middle
Last
Suffix
Mailing Address
City
State
Zip
THIS VEHICLE IS SUBJECT TO THE FOLLOWING FIRST LIEN
16a. Electronic Title Request?
YES (16c cannot be checked)
1st Lienholder Name
16. 1st Lien Date
Mailing Address
16b. Certified Lienholder ID No.
16c. Additional Lien(s)?
YES (Attach Form VTR-267)
City
State
Zip
No Change in
Add
Remove
Odometer
Odometer
17. FOR CORRECTED TITLE,
Change in Vehicle Description
VIN
Year
Make
Ownership
Lien
Lien
Brand
Reading
CHECK REASON(S)
Body Style
Other
18. ODOMETER DISCLOSURE - FEDERAL AND STATE LAW REQUIRES THAT YOU STATE THE MILEAGE UPON TRANSFER OF OWNERSHIP. FAILURE TO
COMPLETE OR PROVIDING A FALSE STATEMENT MAY RESULT IN FINES AND/OR IMPRISONMENT.
, state that the odometer now reads
I,
(no tenths).
(Name of Seller/Agent)
THE MILEAGE SHOWN IS
A - Actual Mileage
N - Not Actual Mileage (WARNING-ODOMETER DISCREPANCY)
X - Mileage Exceeds Mechanical Limits
Exempt
MOTOR VEHICLE TAX STATEMENT
19. CHECK ONLY IF APPLICABLE
I hold Motor Vehicle Retailer's (Rental) Permit No.
§
and will satisfy the minimum tax liability (V.A.T.S., Tax Code
152.046 [c]).
§
GDN or Lessor Number
I am a Dealer or Lessor and qualify to take the Fair Market Value Deduction
(V.A.T.S., Tax Code
152.002 [c]).
Year
Make
Vehicle Identification Number
20a. ADDITIONAL TRADE-INS? (Y/N)
20. DESCRIPTION OF VEHICLE
TRADED IN (if any)
21. SALES AND USE TAX COMPUTATION
- (Previous State)
$
$90 New Resident Tax
(a) Sales Price ($
rebate has been deducted)
)
(b) Less Trade-In Amount, Describe in Item 20 Above
$(
$5 Even Trade Tax
(c) For Dealers/Lessors/Rental ONLY - Fair Market Value
$10 Gift Tax - Use Comptroller Form 14-317
$(
)
Deduction, describe in item 20 above.
$65 Rebuilt Salvage Fee
$
(d) Taxable Amount (Item a. minus Item b./Item c.)
(Diesel Vehicles 1996 and Older > 14,000 lbs. )
2.5% Emissions Fee
$
(e) 6.25% Tax on Taxable Amount (Multiply Item d. by .0625)
(Diesel Vehicles 1997 and Newer > 14,000 lbs. )
1% Emissions Fee
10%
(f) Late Tax Payment Penalty
5% or
$
Exemption claimed under the Motor Vehicle Sales and Use Tax Law because
$
(g) Tax Paid to
(STATE)
(h) AMOUNT OF TAX AND PENALTY DUE
$28 or $33 APPLICATION FEE FOR TEXAS TITLE
(Item e. plus Item f. minus Item g.)
$
(Contact your County Tax Assessor-Collector for the correct fee.)
I HEREBY CERTIFY THAT ALL STATEMENTS IN THIS DOCUMENT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
22.
Signature of SELLER, DONOR, OR TRADER 1
PRINTED NAME (Same as signature ) 1
Date
23.
Signature of SELLER, DONOR, OR TRADER 2
PRINTED NAME (Same as signature ) 2
Date
24.
Signature of PURCHASER, DONEE, OR TRADER 1
PRINTED NAME (Same as signature ) 1
Date
25.
Signature of PURCHASER, DONEE, OR TRADER 2
PRINTED NAME (Same as signature ) 2
Date
WARNING: Transportation Code, 501.155, provides that falsifying information on title transfer documents is a third-degree felony offense punishable by not more than ten (10)
§
years in prison or not more than one (1) year in a community correctional facility. In addition to imprisonment, a fine of up to $10,000 may also be imposed.
Page 1 of 2
Form 130-U (Rev. 8/2013)
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