Year Make Model Identification Number
State or Jurisdiction of Current Title Purchase Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
First Lienholder
Street Address City State Zip Code
Lienholder(s) Information & Authorization
If the lienholder is unable to release the title to the owner, the lienholder may complete and notarize this section of the form to be used in place of the refusal
statement.
I declare I am an authorized agent of the lienholder and certify the following:
r The current lienholder of record is in possession of the title for this unit. The original title will not be released to the owner.
This signed and notarized form and a copy of the front and back of the current title is being returned to the owner above.*
r The current title is held electronically.
This signed and notarized form and a copy of the electronic title receipt or a statement on lienholder letterhead indicating that the title is held electronically is being
returned to the vehicle owner above.*
* Mail completed form and documents to the owner, please do not mail to the Department of Revenue.
Signature of Lienholder Printed Name Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
Motor Vehicle Bureau Phone: (573) 526-3669
Visit
https://dor.mo.gov/motorv/titling.php#newresident
for additional information.
Form 5834 (Revised 12-2020)
Form
5834
Owner - Out-of-State Title Request
Vehicle owner and lienholder: When an individual relocates to the state of Missouri they are required to transfer ownership of their vehicle or unit from the previous state of
residence to Missouri within 30 days of becoming a Missouri resident. To obtain a Missouri title, the ownership document must be surrendered to the Missouri Department of
Revenue.
*If the lienholder is in possession of the title, the owner should obtain the title from the lienholder prior to applying for title.
*If the lienholder refuses or is unable to release the title to the owner, the lienholder should provide the owner:
A statement on letterhead indicating the title will not be released to the owner or this completed form and one of the following:
- A copy of the front and back of the title;
- A copy of the title receipt from an electronic issuing state; or
- A statement from the lienholder indicating the title is held electronically.
Once the owner has received the original ownership document or the statement indicating the title will not be surrendered to the owner and required documents as outlined
above, the owner is eligible to apply for a Missouri title and registration.
When documents other than the original title are surrendered at the time of application, a one-year non-renewable registration will be issued. In this case, a Notice to
Lienholder letter will be sent from the Department of Revenue informing the lienholder that an application for Missouri title has been made. This letter will request the original
title be submitted to the Department. Please do not mail this form or the original ownership document to the Department prior to receiving the ofcial Notice to
Lienholder letter.
The lien will remain in force and the lien will appear on the face of the Missouri title when issued. Missouri titles are mailed to the owner, unless requested to be mailed to the
lienholder.
Name Email Address
Missouri Street, Rural Route, or P.O. Box Telephone Number
City State Zip Code County
Signature Date (MM/DD/YYYY)
Owner InformationVehicle/Unit
__ __ /__ __ /__ __ __ __
( __ __ __ ) __ __ __ - __ __ __ __
Notary Information
Subscribed and sworn before me, this
day of year
State County (or City of St. Louis) My Commission Expires (MM/DD/YYYY)
Notary Public Signature
Notary Public Name (Typed or Printed)
Embosser or black ink rubber stamp seal
__ __ /__ __ /__ __ __ __
