Fillable Form 4809: TO ADD/REMOVE NAME FROM TITLE NOTICE (Missouri)

Fill Online, Printable, Fillable, Blank Form 4809: TO ADD/REMOVE NAME FROM TITLE NOTICE (Missouri) Form

Use Fill to complete blank online MISSOURI pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 4809: TO ADD/REMOVE NAME FROM TITLE NOTICE (Missouri)

On average this form takes 16 minutes to complete

The Form 4809: TO ADD/REMOVE NAME FROM TITLE NOTICE (Missouri) form is 1 page long and contains:

  • 0 signatures
  • 4 check-boxes
  • 61 other fields

Country of origin: US
File type: PDF

BROWSE MISSOURI FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
YEAR MAKE VIN/HIN NUMBER
PURCHASE DATE PREVIOUS TITLE NUMBER NET PRICE (AFTER TRADE-IN)
PASSENGER TRUCK ATV TRAILER MANUFACTURED HOME RV BUS BOAT/VESSEL
OUTBOARD MOTOR (EXCLUDING TROLLING MOTOR) MOTORCYCLE TRICYCLE AUTOCYCLE
MISSOURI DEPARTMENT OF REVENUE
MOTOR VEHICLE BUREAU 573-526-3669
PO BOX 3355, JEFFERSON CITY MO 65105-3355 www.dor.mo.gov/mvdl
NOTICE OF LIEN, LIEN RELEASE, OR AUTHORIZATION
TO ADD/REMOVE NAME FROM TITLE
FOR DOR USE ONLY
FOR DOR USE ONLY REJECT NUMBER
TYPE ALL APPLICATIONS. IF NOT
TYPED, ATTACH COPY OF TITLE.
OWNER
INFORMATION
UNIT
DESCRIPTION
FIRST LIENHOLDER
INFORMATION
SECOND LIENHOLDER
INFORMATION
LIEN RELEASE/NOTARY
INFORMATION
OWNER’S NAME (LAST, FIRST, MIDDLE) AS SHOWN ON TITLE APPLICATION (ONLY FIRST 50 CHARACTERS WILL PRINT ON TITLE)
STREET ADDRESS COUNTY
CITY, STATE, AND ZIP CODE DLN OR FEIN
LIENHOLDER’S NAME AS SHOWN ON TITLE APPLICATION FDIC OR LIENHOLDER ID NUMBER
STREET ADDRESS CITY, STATE, AND ZIP CODE
LIEN DATE LOAN OR UNIT NUMBER
Form
4809
(Revised 08-2019)
NOTICE OF LIEN
(NO NOTARY REQUIRED)
LIENHOLDER’S NAME AS SHOWN ON TITLE APPLICATION FDIC OR LIENHOLDER ID NUMBER
STREET ADDRESS CITY, STATE, AND ZIP CODE
LIEN DATE SUBJECT TO FUTURE ADVANCES? LOAN OR UNIT NUMBER
YES
FIRST LIENHOLDER AUTHORIZES A SECOND LIEN BY SIGNING BELOW
LIENHOLDER’S NAME AS SHOWN ON TITLE PRINTED NAME OF LIENHOLDER’S AGENT SIGNATURE OF LIENHOLDER’S AGENT
NOTARY PUBLIC EMBOSSER OR BLACK
RUBBER STAMP SEAL
STATE COUNTY (OR CITY OF ST. LOUIS) LIEN CREATION DATE RELEASE DATE
SUBSCRIBED AND SWORN BEFORE ME, THIS MY COMMISSION EXPIRES
DAY OF
NOTARY PUBLIC SIGNATURE NOTARY PUBLIC NAME (TYPED OR PRINTED)
A $6.00 processing fee must be submitted with each Notice of Lien.
__ __ /__ __ /__ __ __ __
__ __ __ __
ANY PERSON WHO KNOWINGLY AND INTENTIONALLY SUBMITS A SEPARATE DOCUMENT
RELEASING A LIEN OF ANOTHER WITHOUT THE AUTHORITY TO DO SO SHALL BE GUILTY OF
A CLASS D FELONY. (301.640 RSMo)
__ __ /__ __ /__ __ __ __
__ __ /__ __ /__ __ __ __
LIEN RELEASE—ATTACH TO TITLE
(NOTARY REQUIRED)
THE ORIGINAL DOCUMENT MUST BE SUBMITTED. It is recommended that you retain a copy for your records.
__ __ /__ __ /__ __ __ __ __ __ /__ __ /__ __ __ __
ADD/REMOVE
NAME FROM TITLE
OWNER’S NAME (LAST, FIRST, MIDDLE) AS SHOWN ON TITLE APPLICATION PRINT NAME BEING ADDED OR REMOVED
STREET ADDRESS CITY, STATE, AND ZIP CODE
COUNTY TITLE NUMBER PRINTED NAME OF LIENHOLDER’S AGENT SIGNATURE OF LIENHOLDER’S AGENT
YEAR MAKE VIN/HIN NUMBER
__ __ __ __
ADD
REMOVE
LIENHOLDER AUTHORIZATION FOR OWNERS TO ADD/REMOVE NAME FOR TITLE. (NO NOTARY REQUIRED)
Form 4809 (Revised 08-2019)
IS THIS A CHANGE OF OWNERSHIP? YES NO
Reset Form
Print Form
Form 4809 (08-2019)
PLEASE PERFECT YOUR LIEN IMMEDIATELY!
IMPORTANT: Liens must be led and/or received with the Department within 30 days of the loan date
(perfected) for the lienholder to be protected from the debtor ling for bankruptcy relief.
A $6.00 processing fee must be submitted with each Notice of Lien.
OWNER INFORMATION AND UNIT DESCRIPTION — Complete all applicable blocks.
FIRST LIEN — Complete the FIRST LIENHOLDER INFORMATION section, if applicable.
SECOND LIEN — Complete the FIRST and SECOND LIENHOLDER INFORMATION sections, if applicable.
First Lienholder Authorization — This block must be signed by the rst lienholder when adding
a second lien.
Checks may be accepted as payment. Make checks payable to: Missouri Department of Revenue.
The check must be pre-printed with the check writer’s name, address, bank code, and account number.
It must also include the following information regarding the check writer:
1. Driver license or non-driver license number;
2. Date of birth; and
3. Daytime phone number.
Other restrictions may apply. NOTE: The Missouri Department of Revenue may electronically
resubmit checks returned for insufcient or uncollected funds.
The lienholder will receive a receipt as proof the lien has been perfected.
Submit the completed Notice of Lien (Form 4809) to your local license ofce or by mail to the
following address:
MOTOR VEHICLE BUREAU
301 WEST HIGH STREET
PO BOX 3355
JEFFERSON CITY MO 65105-3355
NOTICE OF LIEN
OWNER INFORMATION AND UNIT DESCRIPTION SECTIONS — Complete all applicable blocks.
FIRST AND SECOND LIENHOLDER SECTIONS — Leave blank.
LIEN RELEASE SECTION — Enter the lienholder’s name as shown on title, the date of release, printed
name of the lienholder’s agent, and signature of lienholder’s agent.
NOTARIZATION — The notary information is required to be completed to release the lien.
NOTE: License Ofce notary service - $2.00
FRAUDULENT LIEN RELEASE — ANY PERSON WHO KNOWINGLY AND INTENTIONALLY
SUBMITS A SEPARATE DOCUMENT RELEASING A LIEN OF ANOTHER WITHOUT THE
AUTHORITY TO DO SO SHALL BE GUILTY OF A CLASS D FELONY. (301.640, RSMo)
LIEN RELEASE
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 4809: TO ADDREMOVE NAME FROM TITLE NOTICE (Missouri)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 24 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document