Fillable Printable Lien Renewal Application For Manufactured Homes

Lien Renewal Application For Manufactured Homes

MVR-6A

(Rev. 5/17)

Owner 1 ID# ______________ __________________________________________________________________________________

Full Legal Name of Owner 1 (First, Middle, Last, Suffix) or Company Name

Owner 2 ID# ______________ __________________________________________________________________________________

Full Legal Name of Owner 2 (First, Middle, Last, Suffix) or Company Name

BODY STYLE

SERIES MODEL

YEAR

RENEWAL OF LIEN

North Carolina Division of Motor Vehicles

LIEN RENEWAL APPLICATION FOR MANUFACTURED HOMES

This form is to certify that an agreement has been executed between the borrower and the lender to renew the maturity date for

the manufactured home listed below. This application must be accompanied with the certificate of title unless it is in the possession

of a prior lienholder. The Division, upon receipt of the application, will procure the title from the prior lienholder for the purpose of

recording the new lien and will return the title to the first lienholder and notify the subsequent lienholder(s) that additional lien(s)

has been noted on the certificate of title.

Title #

VEHICLE SECTION

VEHICLE IDENTIFICATION NUMBER

OWNER SECTION

Residence Address (Individual) Business Address(Firm)

Tax County

Mailing Address (if different from above)

City and State

Zip Code

MAKE

Lienholder (assignor) ________________________________________________________

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:

Notary

Notary Printed

Signature _______________________________________ or Typed Name_____________________________________________

(SEAL)

My Commission Expires ______________________________________

I the owner(s) of the manufacturer home described on this application certify that the information is true and accurate.

Owner's Signature ____________________________________________________________________________________

Date

___________________________ County ________________________________________ State ___________

signed the foregoing document for the purpose stated therein and in the capacity indicated.

Notary

Notary Printed

Signature ________________________________________ or Typed Name _____________________________________________

(SEAL)

The lien, dated _________________, shown in favor of the undersigned lienholder on the attached certificate of title covering a

___________________________________________________________________________________________________________

(YEAR) (MAKE) (BODY STYLE) (VEHICLE IDENTIFICATION NUMBER)

issued in the name of _________________________________________________________________________________________

will reflective a new maturity date of ____________________.

I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily

My Commission Expires ______________________________________

_____________________________________________________________________________________________________________