Certificate Of Sale Repairman'S Lien

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Utah State Tax Commission

TC-839R

Certificate of Sale

Rev. 5/11

(Repairman's Lien)

Division of Motor Vehicles · PO Box 30412, Salt Lake City, UT 84130

· Telephone

801-297-7780 or 1-800-368-8824

Get forms online - tax.utah.gov

Section 1 - Vehicle Information

Vehicle/Hull Identification Number (VIN/HIN)

Make

Model

Year

Body type

Trailer length

Watercraft length

License plate number

State last registered

ft________ in________

Section 2 - Registered Owner Information

Registered owner’s name

Registered owner's address (include street, city, state, and ZIP)

Lien holder’s name

Lien holder's address (include street, city, state, and ZIP)

Section 3 - Repairman Information

Company’s name

Representative’s name

Daytime telephone number

Company’s address (includes street, city, state, and ZIP)

Section 4 - Sales Information

Date of sale

Amount of bid

Amount of repairman’s lien

Date lien became delinquent

Signature of person conducting sale

Date

Section 5 -

Disclosure Statement

and Transfer of Ownership

I certify that the odometer reading: (check one)

Reflects the actual mileage.

Enter odometer reading (no tenths)

Reflects the mileage in excess of the odometer’s mechanical limits.

Is not the actual mileage. Warning - Odometer Discrepancy

I further certify that motor vehicle record information indicates that the outstanding title is: (check one)

Subject and subordinate

to the interests of a

Not branded

Branded (print brand type): __________________________________________

secured lien holder

If branded, you are required by Utah Code 41-1a-1004 to give any prospective purchaser written notification on form TC-814, available at any DMV office.

After lawful advertising and foreclosure of said lien, I certify the vehicle described above was sold to the highest bidder to satisfy a repairman's lien.

The action was taken after due notice of lien was furnished to the registered owner and lien holder of record. Required documentation is attached.

Signature of repairman or representative

Section 6 - New Owner Information

Purchaser’s name

Purchaser's address (include street, city, state, and ZIP)

Purchaser's signature (

I understand that if this vehicle has a secured lien holder, a written lien release must be obtained before a clear title may be issued

)

If you need an accommodation under the Americans with Disabilities Act, contact the Tax Commission at (801) 297-3811 or

Telecommunications Device for the Deaf (801) 297-3819. Please allowing three working days for a response.