A. Date of Application
Odometer reading is miles kilometers
Declared actual vehicle mileage unless one of the following statements is checked:
Stated mileage exceeds odometer’s mechanical limits, or
Stated mileage is not the actual mileage. WARNING-ODOMETER DISCREPANCY
Vehicle or Boat Title Number Serial Number (VIN or HIN)
Make Model/Length Body Type Year Weight
Owner/Owner’s name as it appears on title Owners SDDL# or SSN#
Owner/Owner’s Current Mailing Address City State Zip Code
Special Mailing Name Special Mailing Address City State Zip Code
B.
Moving to another state – Title required to register vehicle in new state of residence
Insurance Claim/Total loss
Court Order
Name: Change, Addition or Deletion of Owner
Other (MUST BE APPROVED BY DMV):
***Please note if no reasons above apply, the duplicate certificate of title with lien will be
ELECTRONIC and NO PAPER TITLE WILL BE GENERATED***
Lienholder Information
By signing, the lienholder is granting approval for the owner to obtain a duplicate title. The lien will appear on the duplicate title,
unless a separate lien release accompanies the application.
1.
Lienholder Signature Lienholder Name Lienholder Address
2.
Lienholder Signature Lienholder Name Lienholder Address
C. Applicant Certification
As the applicant, I certify that the information shown above is true and correct to the best of my knowledge and that I have not
transferred the vehicle or boat described above to another owner, or if it has been transferred, that I am applying for a duplicate title
on behalf of the new owner. I certify the original title has been either Lost, Stolen, Destroyed, Mutilated, Illegible or Never Received
Signature(s) of Applicant/Owners
Subscribed and sworn before me this day of 20
My commission expires
***Notary Public Signature and Seal***
This application is INVALID unless properly notarized by Notary or DMV agent
Instructions
1. This Form must be signed in front of a notary public and submitted with the notary public’s seal affixed.
2. An odometer reading is required on vehicles 9 years old or newer, and on vehicles with a gross vehicle weight of 16,000 lbs. or less.
3. If a lien is indicated on the title record, a lien release must be submitted or lienholder must complete Section B.
4. If the duplicated title is to be mailed to someone other than the owner, the mailing instructions must be indicated on the form.
5. If someone authorized to sign for an owner through a power of attorney is signing this form, a copy of the power of attorney form is required. The
original power of attorney from should be retained in the event it is needed for assigning the duplicate title.
6. Once the form is completed along with a $10 fee, it can be returned to your County Treasurer’s Office or it can be mailed to:
Division of Motor Vehicles, Duplicate Title Section, 445 E. Capitol Avenue, Pierre, SD 57501-3185.
