MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
445 Minnesota Street
Saint Paul, MN 55101-5197
Phone: (651) 297-2126 TTY/TDD: (651) 282-6555
Web: dvs.dps.mn.gov
Affidavit Regarding Due Diligence
Use this form when your vehicle is six model years or older and it cannot be titled or registered because you do not have the required title documents,
pursuant to Minn. Stat. § 168A.07 (Laws 2012, ch.287).
INSTRUCTIONS:
1.
2.
Print or type to complete this form: Affidavit Regarding Due Diligence (PS2026).
The form and additional documents noted below must be submitted at a Deputy Registrar office. To determine the amount due and to find
the office nearest to you, visit dvs.dps.mn.gov
or call (651) 297-2126. Do not mail in the form.
NOTE: You must provide evidence of this valuation, such as a printout of the NADA or Blue Book price guide or other
documentation. Picture(s) should clearly show all sides of the vehicle.
I (full name of applicant) being sworn/affirmed on oath state:
Model Year
Vehicle Identification Number
VEHICLE DESCRIPTION
Make
The vehicle is six model years or older (current calendar year - vehicle model year = six or more);
I have attached a completed Application for Title, and all required taxes and fees have been paid;
I am an owner of the vehicle; and
I have physical possession of the vehicle.
In attempting to transfer interest in the vehicle or obtain a certificate of title or lien release, I was unable
after using due diligence to (check one):
(A) Determine the names or locations of one or more owners, prior owners, or lienholders; OR
(B) Successfully contact one or more owners, prior owners, or lienholders known to me.
List the fair market value of this vehicle.
Evidence of this and pictures of the vehicle are attached.
I purchased the vehicle from:
Name of seller
Address of seller
Model Type Plate Number
Verification and Acknowledgement
I swear/affirm under oath, that the statements set forth herein are true and correct to the best of my knowledge and belief.
PS2026-04 (02/16)
Printed or Type Name of Petitioner (Applicant)
Signed and attested before me on _____________________________ (date)
Notary Signature
X
Signature of Petitioner (Applicant)
X
County State My Commission Expires
Notary Stamp
Date of Sale
CHECK ALL
In order to qualify, applicant must attest by checking all boxes:
FAIR MARKET VALUE AND BUYER/SELLER INFORMATION
(address of applicant)
