Fillable Printable Form MV-900.1 - Notice of Lien - Charge Account Customer - New York

Form MV-900.1 - Notice of Lien - Charge Account Customer - New York

Lienholder’s Name (continued)

Lien Filing Code (assigned by DMV:

enter only if a code has been assigned to you or your company)

±________________________________________________________________________ Date of Security Agreement_________________________

Has a NY Certificate of Title been issued to this borrower?

 YES  NO IF YES, ATTACH TITLE.

OWNER’S STATEMENT: I understand that the lienholder will send this notice to the DEPARTMENT OF MOTOR VEHICLES. If a title was

previously issued in my name for this vehicle, boat, trailer or manufactured home, I gave it to the lienholder to be sent to DMV with this notice.

I understand that a new Certificate of Title, showing the lienholder’s name, will be mailed to me.

OWNER(S): SIGN HERE

± _______________________________± ________________________________ Date _______________

If signing for a corporation, print your name and title:

______________________________________ ________________________________

New York State Department of Motor Vehicles

NOTICE OF LIEN - CHARGE ACCOUNT CUSTOMER

All information (other than signature) must be typed. Use caution when entering Vehicle, Hull or Manufactured Home ID number.

Liens will not

be recorded if information is illegible, incorrect or incomplete.

NOTE: Lien will be recorded only if the name(s) listed as the owner(s) is EXACTLY the same as the owner(s) recorded, or to be recorded, on

the Certificate of Title. If a Certificate of Title has not been issued to this borrower, print the name as it appears on the driver license.

MV-900.1 (1/11)

Identification

Number

Year

This is a:

 Vehicle  Boat  Trailer  Manufactured home

Make Body Type/

Hull

Registration/Plate No.

of Borrower, if any

Owner’s Last Name

First M.I.

Owner’s Last Name

First M.I.

Street Address (including Apt. No.)

City

State Zip Code

Lienholder’s Name

Street Address

City

(Lienholder’s Signature—Must be an original signature or a facsimile stamp)

This notice authorizes the Department of Motor Vehicles to disclose (or otherwise make available) information about the lienholder obtained by

the department in connection with this record.

LIENHOLDER: Mail this form and the owner’s title (if issued) to:

TITLE BUREAU, NEW YORK STATE DEPARTMENT OF MOTOR VEHICLES PO BOX 2604, ALBANY, NY 12220-0604

(Must be an original signature. If a POA is used,

a copy of the POA must be attached.)

(Name)

(Title)

(Must be an original signature. If a POA is used,

a copy of the POA must be attached.)

www.dmv.ny.gov

VEHICLE/BOAT/MANUFACTURED HOME INFORMATION

OWNER INFORMATION

Check here if this is a new address

LIEN INFORMATION

PLEASE TYPE LIEN FILING CODE, AND NAME AND ADDRESS OF THE ACCOUNT TO BE CHARGED:

Account Name

Street Address (including Apt. No.)

City or Town State Zip Code

Lien Filing Code: Vehicle Identification

Number (VIN):

DO NOT DETACH THIS RECEIPT

YOUR DMV CHARGE ACCOUNT NUMBER: _____________________

Your DMV Charge Account Number: _____________________

MV-900.1 (1/11)

You can verify online if a lien was recorded or if a title certificate was issued.

Go to the Lien/Title Certificate Status page at the DMV web site: www.dmv.ny.gov/titlestat/default.html

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