Title Acquisition Form Title Acquisition Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.NOTE: Private Parties, Auctions, Recovery Services, Transport Companies can submit for lost title or no title processing below. Customer Information Contact NamePhoneNEW Title Info: FULL NAME *Email *AddressAddress Line 1CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeVehicle Information Year, Make & Model - 1License Plate-1Value Of Vehicle-1Do you have a BILL OF SALE? - 1Yes, (please upload, originals needed)No, (title bond assistance)(Statement of Facts)V.I.N-1License State-1HOW did you get the vehicle? - 1It was released to me by... (left on property)I purchased the vehicle from..It was a Gift.It was a Family Gift.(Statement of Facts)Mileage-1 (if known)Total Storage Due (30days)-1FROM WHO and WHEN did you get the vehicle from? - 1(Statement of Facts)Year, Make & Model - 2License Plate-2Value Of Vehicle-2Do you have a BILL OF SALE? - 2Yes, (please upload, originals needed)No, (title bond assistance)(Statement of Facts)V.I.N-2License State-2HOW did you get the vehicle? - 2It was released to me. (left on property)I purchased the vehicle.It was a Gift.It was a Family Gift.(Statement of Facts)Mileage-2 (if known) Total Storage Due (30days)-2FROM WHO and WHEN did you get the vehicle from? -2(Statement of Facts)Year, Make & Model - 3License Plate-3Value Of Vehicle-3Do you have a BILL OF SALE? - 3Yes, (please upload, originals needed)No, (title bond assistance)(Statement of Facts)V.I.N-3License State-3HOW did you get the vehicle? - 3It was released to me. (left on property)I rurchased the vehicle.It was a Gift.It was a Famliy Gift.(Statement of Facts)Mileage-3 (if known)Total Storage Due (30days)-3FROM WHO and WHEN did you get the vehicle from? -3(Statement of Facts)Please upload the BILL OF SALE or ANY DMV documents. Click or drag files to this area to upload. You can upload up to 5 files. Terms & Conditions: I, the undersigned, hereby certify, under penalty of perjury, that I am the authorized person for the referenced vehicle and have supplied LienWorks Inc., with the names and addresses of any and all parties known by me to have an interest in the above-mentioned vehicles, any parties that have authorized storage and release, as well as performed the proper due diligence in valuing all vehicles listed on this form or have emailed correspondence to info@lienworks.net. I also understand that this Diligent Effort is being processed based upon the information herein, according to https://www.dmv.ca.gov/portal/handbook/vehicle-industry-registration-procedures-manual-2/bonds-and-certifications/diligent-effort-process/ and agree to indemnify and hold harmless LienWorks, Inc., from any legal action arising out of the processing of this lien, including, but not limited to, attorney fees, court costs, and judgments. The California Department of Motor Vehicles holds exclusive authority over the printing and mailing of all California titles at their discretion. DISCLAIMER: DUE TO DMV INDUSTRY POLICY; DMV FEE ESTIMATES PAID, ARE APPLIED AS CREDIT, & ARE NON-REFUNDABLE. Do you understand these terms & conditions? *YesNoI agree to these Terms & Conditions *YesSUBMIT!
