Amend/Lienholder Maintenance/ Duplicate Title Application: Service Type

Amend/Lienholder Maintenance/
Duplicate Title Application

Registry of Motor Vehicles · Title Division
P.O. Box 55885 · Boston, MA 02205-5889
Service Type
Please read the following instructions before completing this application.
Request to (check one):
□ Add a Lienholder □ Correct a Title
1. Complete Sections A, B, and D only 1. Complete Sections A, C, D, and F (if applicable)
2. Mail completed application and original certificate of title to 2. Mail completed application and original certificate of title to address at
address at top of application top of application
3. Include $25 check or money order 3. Include $25 check or money order made payable to MassDOT
□ Apply for a Duplicate Title

1. If you obtained a loan for this vehicle and that loan has been satisfied, please check with your lienholder (e.g., bank) first to see if they have
your title. If they do not, get a signed letter from the lienholder on their letterhead indicating that the loan has been satisfied. The letter must also
specify the year, make, vehicle identification number (VIN), and all titled owners. No faxes or photocopies of lien releases are acceptable. The lien
release must be submitted with your application for a duplicate title, regardless of the age of the loan.
□ If the party to whom the title was issued is deceased, a copy of the letter of administration, court order, or affidavit of surviving spouse and a death
certificate must accompany this application.
2. Complete Sections A, D, E, F, and G (if applicable)
3. Mail completed application and supporting documentation (if applicable) to address at top of application
4. Include $25 check or money order made payable to MassDOT
A. Owner and Vehicle Information

Registration Number Year Make VIN Number Title Number
Owner Name (Last, First, Middle) or Corp/Co Organization Name:
Owner’s Address City State Zip Code
B. Adding a Lienholder (Original Certificate of Title Must Be Submitted with This Application)
Date of Lien Lienholder Code Lienholder Name (Last, First, MI)
Corp/Co Organization Name
Address City State Zip Code
C. Correcting Title (Original Certificate of Title Must Be Submitted with This Application)
Enter information to be corrected (a notarized affidavit of facts must accompany this form to correct the odometer):
D. Signatures (Original Certificate of Title Must Be Submitted with This Application)
I swear (affirm), under the penalties of perjury, that the information provided is true and correct. I am aware that false statements are punishable by fine,
imprisonment, or both under M.G.L. Chapter 90, Section 24B.
Signature(s) of Owner(s) or Lienholder Date
Printed Name(s)
TTL104_1119
E. Applying for Duplicate Title If mutilated is selected, the Certificate of Title must be submitted with this application.
I,
hereby make application, in accordance with Chapter 90D, Section 14, of the General Laws, for duplicate certificate of title which the original was:
Lost Stolen Mutilated Destroyed

A person recovering an original certificate of title for which a duplicate has been issued shall promptly surrender the original to the Registrar (Chapter
90D, Section 14[c]).
F. Mail Title to:

The Certificate of Title will only be mailed to: (1) the owner’s mailing address entered on the RMV’s system, (2) a car dealership, (3) a lienholder, or (4)
an insurance agent. If the title is to be mailed to a dealer, Section G must be completed.
Mail to address below: Check box if you are authorizing the RMV to change your address
Name
Address
City State Zip Code
G. Duplicate Signature (only required if transferring ownership to dealership)
I/ We, the undersigned, hereby authorize the Registry of Motor Vehicles to mail to the dealership identified below a duplicate Certificate of Title to be
issued in my name in order to transfer ownership of the motor vehicle described herein. Note, this form does not constitute a Power of Attorney or a
Reassignment.
Name of Transferee/Dealer
Address
Dealer Registration Number Year Make VIN
I state that the odometer now reads (no tenths) and that to the best of my knowledge it reflects the actual mileage of the
vehicle unless one of the following statements is checked:
□ I certify that, to the best of my knowledge, the odometer reading reflects the amount of mileage in excess of its mechanical limits. (The odometer
starting at zero again.)
□ I certify the odometer reading is not the actual mileage. “WARNING—Odometer Discrepancy”
Signature(s) of Transferor(s)—Owner(s) as It Appear(s) on Title
Printed Name(s) Date
TTL104_1119

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Amend/Lienholder Maintenance/

Duplicate Title Application

□ Apply for a Duplicate Title

A. Owner and Vehicle Information

Owner Name (Last, First, Middle) or Corp/Co Organization Name:

Owner’s Address City State Zip Code

Date of Lien Lienholder Code Lienholder Name (Last, First, MI)

Corp/Co Organization Name

Address City State Zip Code

D. Signatures (Original Certificate of Title Must Be Submitted with This Application)

Signature(s) of Owner(s) or Lienholder Date

Lost Stolen Mutilated Destroyed

F. Mail Title to:

City State Zip Code

G. Duplicate Signature (only required if transferring ownership to dealership)

Dealer Registration Number Year Make VIN

Signature(s) of Transferor(s)—Owner(s) as It Appear(s) on Title

Printed Name(s) Date

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