Fillable Additional Liens Statement

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Additional Liens Statement

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Additional Liens Statement
Information
This form must be submitted with the Application for Texas Title and/or Registration (Form 130-U) when
more than one lien needs to be recorded on the Texas title.
More than one lien cannot be recorded in combination with an electronic lien. If more than one lien is
recorded, a paper title will be issued to the first lienholder listed on the Application for Texas Title and/or
Registration (Form 130-U).
Vehicle Information
Vehicle Identification Number
Year
Make
Body Style
Model
Additional Lien Information
Second
Lien
Lien Date
Certified Lienholder ID Number
Mailing Address
City
State
Zip
Third
Lien
Lien Date
Certified Lienholder ID Number
Mailing Address
City
State
Zip
Certification – State law makes falsifying information a third degree felony
I certify the motor vehicle described above is subject to the these additional lien(s) in addition to the first lien recorded
on the attached Application for Texas Title and/or Registration (Form 130-U).
Signature of Applicant/Owner
Printed Name (Same as Signature)
Date
Signature of Additional Applicant/Owner (if any)
Printed Name (Same as Signature)
Date
VTR-267 Rev 08/16 Form available online at www.TxDMV.gov Page 1 of 1
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Additional Liens Statement

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Completed 28 January 2021

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