Fillable Printable Vehicle Deposit Form - California
Fillable Printable Vehicle Deposit Form - California
Vehicle Deposit Form - California
REG 5059 (NEW 1/2010)
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STATE OF CALIFORNIA
Department of Motor Vehicles
Registration Operations Division
P.O. Box 942869
Sacramento, CA 94269-0000
(800) 777-0133
A Public Service Agency
DMV USE ONLY
VIN
MAkE
VEHICLE, VESSEL OR OFF-HIGHWAY VEHICLE TITLE
DEPOSIT AGREEMENT AND ASSIGNMENT
(Vehicle Code Sections 4157, 4158, 9923, 9924, 38050, 38055, Code of Civil Procedure section 995.710)
(Submit in Duplicate)
VEHICLE, VESSEL OR OFF-HIGHWAY VEHICLE INFORMATION
The vehicle, vessel, or off-highway vehicle subject of this agreement is described as follows:
Make: ____________________ Model: ___________________ Year: _________________________________________
Current state of registration: ____________________________ VIN or HIN: ___________________________________
Current plate, registration or assigned identication number: _________________________________________________
Current value of the vehicle, vessel, or off-highway vehicle: __________________________________________________
DEPOSITOR INFORMATION
(TRUE FULL NAME OF DEPOSITOR(S))
Referred to here as “Depositor,” whether one or more, whose address for service is:
(MAILING AND PHYSICAL ADDRESS)
Agrees that the Department of Motor Vehicles may collect, sell, or otherwise apply the deposit to enforce the liability
of the Applicant, and that the Depositor is held and rmly bound to the People of the State of California in the penal
sum of dollars ($ ) for which payment we bind ourselves, our heirs, executors,
administrators, successors and assigns jointly and severally, rmly by these presents.
(FULL TRUE NAME OF APPLICANT FOR CALIFORNIA TITLE)
Whose address for service of process is:
(ADDRESS)
Referred to here as the “Applicant,” is the person whose obligation is the subject of this agreement and deposit. The Applicant
may be the same person or entity as the Depositor.
DEPOSIT INFORMATION
The property deposited is, as follows:
(1) Lawful money of the United States in the amount of $ . The money shall be maintained by
the department in an interest-bearing trust account; and, if no proceedings are pending to enforce the liability of the
vehicle, vessel, or off-highway vehicle on the deposit, the State shall pay quarterly, on demand, any interest on the
deposit, when earned in accordance with the terms of the account or certicate, to the Depositor.
(2) Bearer bonds or bearer notes of the United States or the State of California.
(DESCRIBE IN DETAIL)
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(3) Certicates of deposit payable to the department, not exceeding the federally insured amount, issued by:
(NAME AND ADDRESS OF FINANCIAL INSTITUTION)
a bank or savings association authorized to do business in this state and insured by the Federal Deposit Insurance
Corporation, issued or dated , identied by number , in the
(ISSUE DATE) (ACCOUNT NUMBER)
amount of $ .
(DOLLAR AMOUNT)
(4) A savings account, investment certicate or share account not exceeding the federally insured amount, together with
evidence of the deposit in the accounts with:
(NAME AND ADDRESS OF FINANCIAL INSTITUTION)
a bank or savings association authorized to do business in this state and insured by the Federal Deposit Insurance
Corporation, issued or dated , identied by number in the amount of
(ISSUE DATE) (ACCOUNT NUMBER)
$ .
(DOLLAR AMOUNT)
(5) A certicate for funds or share account, not exceeding the guaranteed amount, issued by:
(NAME AND ADDRESS OF FINANCIAL INSTITUTION)
a credit union, as dened in Section 14002 of the Financial Code, whose share deposits are guaranteed by the
National Credit Union Administration or guaranteed by any other agency approved by the Department of Financial
Institutions, issued or dated , identied by number , in the amount of
(ISSUE DATE) (ACCOUNT NUMBER)
$ .
(DOLLAR AMOUNT)
WHEREAS: the provisions of Sections 4157, 9923 and 38050 of the Vehicle Code, and Sections 152.00 and 190.03, Title 13,
of the California Code of Regulations require that the Applicant le or have on le with the Department a bond in an amount
equal to the value of the vehicle, vessel or off-highway vehicle for which documentary evidence of ownership is requested
when the Applicant is unable to provide the regularly required supporting evidence of ownership; and the Applicant may give
a deposit in lieu of a bond under section 995.710 of the Code of Civil Procedure; section 995.710 requires an agreement to
accompany the deposit; and subdivisions (a)(4), (a)(5) and (a)(6) of section 995.710 require an assignment to give effect to
a deposit under those subdivisions; this agreement is executed and tendered, the deposit given, and the assignment made,
in accordance therewith.
NOW THEREFORE, the conditions of the foregoing obligations are: that if, the department, any officer or employee of the
department, any subsequent purchaser of the vehicle, any person acquiring a lien or security interest in the vehicle, any
successor in interest of a purchaser or person, does not suffer any loss or damage on account of any defect in or undisclosed
claim upon the right, title and interest of the Applicant or other person in and to the vehicle, vessel or off-highway vehicle,
then this obligation is to be void; otherwise it is to remain in full force and effect.
FURTHER, the Depositor hereby assigns to the Department of Motor Vehicles: the accounts, investment certicates, share
accounts, certicates for funds, or other accounts described herein; and, any insurance or guarantee by the Federal Deposit
Insurance Corporation, National Credit Union Administration, any similar insurance or guarantee by an agency approved by
the Department of Financial Institutions, or any other similar insurance or guarantee relating to the deposit.
PROVIDED HOWEVER, this agreement and deposit is executed, tendered and given subject to the following express
conditions:
1. This agreement and deposit shall be deemed continuous in form and shall remain in full force and effect and shall run
concurrently with the period for which the evidence of ownership is granted and each and every succeeding period or
periods for which said evidence of ownership continues in place, after which liability hereunder shall cease except as to
any liability or indebtedness therefore incurred or accrued before the cancellation or withdrawal of the Depositor from the
agreement and deposit.
2. This agreement, deposit and assignment is executed, tendered and given by the Depositor to comply with the provisions
of Sections 4157, 4158, 9923, 9924, 38050 and 38055 of the Vehicle Code, chapter 2, (commencing with section
995.010), title 14, part 2 of the Code of Civil Procedure, and Sections 152.00 and 190.03, Title 13, of the California Code
of Regulations, and said agreement and deposit shall be subject to all the terms and provisions thereof.
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3. The aggregate liability of the Depositor under this agreement and deposit on all claims whatsoever shall not exceed the
penal sum of this deposit in any event; however, the liability of the Applicant is not limited.
4. This agreement and deposit may be cancelled by the Depositor in accordance with the provisions of Article 13
(commencing with section 996.310), chapter 2, title 14, part 2 of the Code of Civil Procedure.
5. The Depositor, its successors and assigns, are jointly and severally liable on the obligations of the agreement and
deposit, the provisions of Chapter 2 (commencing with section 995.010), title 14, part 2 of the Code of Civil Procedure,
Sections 4157, 9923 and 38050 of the Vehicle Code, and Sections 152.00 and 190.03, Title 13, of the California Code of
Regulations.
6. The Depositor and Applicant may be served with notices, papers and other documents under chapter 2 (commencing
with section 995.010), title 14, part 2 of the Code of Civil Procedure at the addresses given prior within this document.
7. Any interest earned on funds represented by a certicate of deposit payable to the department or on funds in an account
in a nancial institution shall be the property of the Depositor, is not subject to this assignment and agreement, and may
be paid to the Depositor by the nancial institution.
A copy of the evidence of the deposit (a DMV cash deposit receipt, bonds or notes, certicates of deposit, passbook, etc.)
may be attached to this agreement and assignment for the purpose of further identifying the deposit. The undersigned
executes this deposit in lieu of a bond on behalf of the depositor under an unrevoked power of attorney.
I certify (or declare) under penalty of perjury, under the laws of the State of California that the foregoing is true and
correct.
SIGNATURE OF DEPOSITOR
On (Date): , 20
PRINTED OR TYPED NAME AND TITLE
***STOP***
****DO NOT CONTINUE BELOW THIS LINE***
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To Be Completed by a Financial Institution
When the Deposit Resides in the Financial Institution
Acknowledgment by Financial Institution:
Receipt is hereby acknowledged to the Department of Motor Vehicles of the State of California, of written notice of the
assignment of the above-described account to the department. We have noted our records to show the interest of the
department in the account created by the assignment. We have retained a copy of this document. We hereby certify that
we have not received any notice of lien, encumbrance, hold, claim or other obligation against the above account prior to
its assignment to the department. We agree to make payment in accordance with the laws applicable to this institution. We
further agree that notwithstanding anything to the contrary, the full sum of the deposit as shown on the above agreement
and assignment shall be available for payment to the department and shall not be reduced on account of any penalty
for early withdrawal or other cause, or to pay service or other fees to the institution. We note that interest earned on the
deposit is the property of the Depositor, not subject to this assignment and agreement, and may be paid to the Depositor.
NAME OF FINANCIAL INSTITUTION
On (Date): , 20
ExECUTED AT (CITY AND COUNTY) IN CALIFORNIA
SIGNATURE OF OFFICER OF FINANCIAL INSTITUTION
PRINTED OR TYPED NAME OF OFFICER AND TITLE
TELEPHONE NUMBER
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ADDENDA TO VEHICLE, VESSEL OR OFF HIGHWAY VEHICLE TITLE
DEPOSIT AGREEMENT AND ASSIGNMENT
In the event insufficient space has been provided on the Vehicle, Vessel or Off highway Vehicle Deposit Agreement and
Assignment form for the entry of required information, this page may be used to provide the information required. If this page
is used, “See addenda item no. __”: or similar language must be entered in the blank provided in the form, with a number
entered; and, each item included in this page must be separately numbered to correspond to the numbered reference on the
face of the form.
If used, this page must be dated and signed by the same person or persons who signed the form.
DATE BY
PRINTED NAME
