PLEASE DESCRIBE THE VEHICLE ACCURATELY
MAKE OF VEHICLE (PRINT) MODEL YEAR COLOR BODY TYPE
COMPLETE VEHICLE IDENTIFICATION NUMBER (NOT THE MOTOR NUMBER) NO. OF AXLES
DATE OF BIRTH
I
ODOMETER
READING
TENTHS
PLEASE
CHECK
"
YES
"
OR
"NO"
Does your vehicle now have a lien?
(Is
your vehicle financed?) Yes
No
SEX
If you checked "yes"
PRINT
name and address of bank or finance company below. If you checked "No", print 'NONE" in the box below.
NAME OF BANK OR FINANCE COMPANY (LIENHOLDER), IF NO LIEN PRINT "NONE"
LIENHOLDER CORPCODE
STREET ADDRESS OF LIENHOLDER
NAME AND ADDRESS
OF
OWNER AND CO
-
OWNER BELOW
STREET
CITY, STATE, ZIP CODE
STATEMENT OF
APPLICANT(S):
The undersigned hereby certifies all
of
the above to be true and correct and that the identification
number shown on this form has been compared to the identification number on the motor vehicle and further certifies that they agree
in every particular.
SIGN SIGN
HERE
x
HERE
CO
-
OWNER (if any) DATE CO
-
OWNER (if any) DATE
OS/SS-7 (R2/09)
OWNER DATE CO-OWNER (if any) DATE
SIGN
SIGN
HERE HERE
APPLICATION FOR CERTIFICATE OF OWNERSHIP
CITY, STATE, ZIP CODE
STREET
DATE OF BIRTH
NAME
N.J. DRIVER LICENSE NO. (IF BUSINESS-CORPCODE)
N.J. DRIVER LICENSE NO. (IF BUSINESS-CORPCODE)
NAME
EYE COLOR
EYE COLOR SEX
LIENHOLDER
OWNERCO-OWNER
x
x
x
NJ Motor Vehicle Commission
Special Services Titles
P.O. Box 017
Trenton, NJ 08666-0017
Purchase Price $ ______________________
Sales/Use Tax $ ______________________
Ex. Code__________ Initials_____________
