Fillable Printable Certification Of Repossession
Fillable Printable Certification Of Repossession
Certification Of Repossession
North Carolina Department of Transportation
DIVISION OF MOTOR VEHICLES
CERTIFICATION OF REPOSSESSION
This is to certify that the undersigned has repossessed the motor vehicle described because of the failure
of the former owner to meet his obligation in the matter of settlement of the lien described on the face of the
attached certificate of title. No suit is now pending in court concerning this repossession. l/we hereby war-
rant title to this described vehicle to be free from all indebtedness and agree to defend it against all claims.
YEAR MAKE BODY STYLE SERIES MODEL
TITLE NUMBER VEHICLE IDENTIFICATION NUMBER
Current Odometer Reading
North Carolina General Statute 20-77(a) provides that whenever the title or interest of an owner in or to a
vehicle shall pass to another by operation of law, as upon order in bankruptcy, execution sale, reposses-
sion upon default in performing the terms of a lease or executory sales contract, or otherwise than by vol-
untary transfer, the transferee shall secure a new certificate of title upon proper application, payment of the
fees provided by law, and presentation of the last certificate of title, if available, and such instruments or
documents of authority or certified copies thereof as may be sufficient or required by law to evidence or
effect a transfer of interest in or to chattels in such cases.
_________________________________________________________________
NAME OF SECURED PARTY
BY: _______________________________________________________________
AUTHORIZED REPRESENTATIVE
Date: _____________ County: ______________________________________ State: ______________
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he
or she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated:
__________________________________________________________________ (name(s) of principal(s).
Notary Signature: ________________________________________________________________________
Printed or typed name: ____________________________________________________________________
(SEAL) My commission expires: ____________________
MVR-3 (Rev. 1/06)
NAME OF
DEFAULTING
OWNER
ADDRESS OF
DEFAULTING
OWNER
SECURITY
INTEREST
STREET ADDRESS (NUMBER AND STREET OR R.F.D. AND BOX NUMBER)
CITY STATE ZIP CODE COUNTY
DATE OF LIEN DATE OF REPOSSESSION STATE ISSUED
NAME OF SECURED PARTY
ADDRESS OF SECURED PARTY
North Carolina Department of Transportation
DIVISION OF MOTOR VEHICLES
CERTIFICATION OF REPOSSESSION
This is to certify that the undersigned has repossessed the motor vehicle described because of the failure
of the former owner to meet his obligation in the matter of settlement of the lien described on the face of the
attached certificate of title. No suit is now pending in court concerning this repossession. l/we hereby war-
rant title to this described vehicle to be free from all indebtedness and agree to defend it against all claims.
YEAR MAKE BODY STYLE SERIES MODEL
TITLE NUMBER VEHICLE IDENTIFICATION NUMBER
Current Odometer Reading
North Carolina General Statute 20-77(a) provides that whenever the title or interest of an owner in or to a
vehicle shall pass to another by operation of law, as upon order in bankruptcy, execution sale, reposses-
sion upon default in performing the terms of a lease or executory sales contract, or otherwise than by vol-
untary transfer, the transferee shall secure a new certificate of title upon proper application, payment of the
fees provided by law, and presentation of the last certificate of title, if available, and such instruments or
documents of authority or certified copies thereof as may be sufficient or required by law to evidence or
effect a transfer of interest in or to chattels in such cases.
_________________________________________________________________
NAME OF SECURED PARTY
BY: _______________________________________________________________
AUTHORIZED REPRESENTATIVE
Date: _____________ County: ______________________________________ State: ______________
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he
or she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated:
__________________________________________________________________ (name(s) of principal(s).
Notary Signature: ________________________________________________________________________
Printed or typed name: ____________________________________________________________________
(SEAL) My commission expires: ____________________
MVR-3 (Rev. 1/06)
NAME OF
DEFAULTING
OWNER
ADDRESS OF
DEFAULTING
OWNER
SECURITY
INTEREST
STREET ADDRESS (NUMBER AND STREET OR R.F.D. AND BOX NUMBER)
CITY STATE ZIP CODE COUNTY
DATE OF LIEN DATE OF REPOSSESSION STATE ISSUED
NAME OF SECURED PARTY
ADDRESS OF SECURED PARTY
