Get Nm Mvd-10901 2005

State of New Mexico - Motor Vehicle Division MVD - 10901 REV. 11/05 APPLICATION FOR DUPLICATE CERTIFICATE OF TITLE CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE OWNER INFORMATION Phone Number Name of Owner s Address City State Zip Code TITLE INFORMATION Title No. Original Title was Lost Stolen Mutilated Never Surrendered by Seller VEHICLE / VESSEL INFORMATION Year Make Model Body Type Series Vehicle or Hull Identification Number Secondary or Engine Number Vehicle License Plate Number Boat Registration Number Overall Boat Length ft. Boat Beam in* Width Boat Transom ft. Depth LIENHOLDER INFORMATION IF APPLICABLE Lienholder s Name Lien Maturity Date NOTICE Payment of the registration fee and acceptance of the application by the Motor Vehicle Division constitutes an affirmation that the applicant for title and registration has complied with the requirements of the Mandatory Financial Responsibility Act NMSA 1978 66-5-201 through 66-5-239. APPLICANT CERTIFICATION I hereby certify that the information given herein is true and correct to the best of my knowledge and affirm that Ihave complied with the requirements of the Mandatory Financial Responsibility Act with respect to this vehicle. Printed Name of Applicant Applicant s Signature Date The Division is not responsible for false or fraudulent statements the applicant/registered owner makes in connection with this application nor is the Division liable for lien recording errors. The registered owner must notify the Division of any errors contained in the title and registration issued pursuant to this application* APPLICANT INSTRUCTIONS Applicant must be the registered owner legal owner successor in interest or legal representative. If applicant is the legal representative of the owner proof of Power of Attorney must be provided* If original title reflects an outstanding lien applicant must provide a Release of Lien or the Duplicate Title will be mailed to Lienholder. If you are out of state applying by mail original title is on file and there is no lien the Duplicate Title will be mailed to the New Mexico address of record unless applicant provides a pre-addressed envelope indicating a different address. If there is no original title on file and the vehicle or vessel is inoperable located out-of-state or cannot be brought in to a New Mexico MVD field office applicant must arrange for the V. I. N*/H. I. N* Inspection portion of the application to be completed* FEES VEHICLE TITLE 16. 50 VESSEL BOAT TITLE 10. 00 ADD OR DELETE A LIEN 5. 00 IN-STATE APPLICANTS MUST OBTAIN DUPLICATE TITLE AT YOUR LOCAL MVD FIELD OFFICE* IF OUT OF STATE AND APPLYING BY MAIL DO NOT SEND CASH. Make check or money order payable to the Motor Vehicle Division* If applying by mail send application supporting documentation and fee to SERVICES BUREAU P. Boat Beam in* Width Boat Transom ft. Depth LIENHOLDER INFORMATION IF APPLICABLE Lienholder s Name Lien Maturity Date NOTICE Payment of the registration fee and acceptance of the application by the Motor Vehicle Division constitutes an affirmation that the applicant for title and registration has complied with the requirements of the Mandatory Financial Responsibility Act NMSA 1978 66-5-201 through 66-5-239. APPLICANT CERTIFICATION I hereby certify that the information given herein is true and correct to the best of my knowledge and affirm that Ihave complied with the requirements of the Mandatory Financial Responsibility Act with respect to this vehicle. .