Application for Repossession of a Vehicle
Title and Registration Bureau
1003 Buckskin Drive, Deer Lodge, MT 59722-2375
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Phone (406) 846-6000 Fax (406) 846-6039 mvdtitleinfo@mt.gov
For purposes of this document, "vehicle" includes a motor vehicle, trailer, semi-trailer, pole trailer, camper, motorboat, personal watercraft, sailboat and snowmobile. The appropriate title fee must be submitted with this application:
$12 for automobiles, vans, SUVs, trucks, buses and logging trucks - all weighing one ton or less. $10 for all other vehicles. Make checks payable to "State of Montana".
I certify that:
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I (or the firm, company or corporation I represent) residing at entered into a security agreement with residing at on the following vehicle: Year Ton Identification No. Make License Plate Number Color Title No. day of , 20 I lawfully repossessed the vehicle; Style
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on the
I (or the firm, company or corporation I represent) have been in continuous and undisputed possession of said vehicle from the date of repossession stated above to the present time; I make this application for the purpose of establishing ownership to said vehicle in order to obtain a certificate of title under Section 61-3-221, MCA, and to release the security interest that has been filed against this vehicle; I indemnify the Chief of the Title and Registration Bureau and all persons acting for him/her from any and all liability that may be incurred by transferring the certificate of title and agree to defend, at my own expense, any suit brought against the Chief or any person acting for him/her as a result of issuing this title; Under penalty of law (Section 45-7-203, MCA, Unsworn Falsification to Authorities) the statements made and information contained on this form are true and correct to the best of my knowledge, information and belief and, if signing for a commercial entity, I have full authority to do so day of , 20
This is my legal signature
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Dated this
Driver's License Number: Printed Name:
Applicant’s Signature:
MV11 (08/05)
Montana county and state authorities reserve the right to reject any form that has been altered
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