VP-147 (Revision Date September 2015) (Page 2 of 2)
LIEN CLAIMANT’S CERTIFICATION
Federal law requires that you state the mileage upon transfer of ownership. Failure to complete or provide a false statement
may result in fines and/or imprisonment. This vehicle was an involuntary transfer; at the time of sale the odometer reading:
Odometer Reading (as shown on apparatus) NO TENTHS
1. The mileage stated is in excess of its mechanical limits.
2. The odometer reading is not the actual mileage. WARNING – ODOMETER DISCREPANCY
3. Exempt – Model year over 9 years old.
To the best of my knowledge, at the time of lien sale this vehicle is (select any that may apply)
Salvage Flood Damaged Total Loss Rebuilt Non-Repairable (Non-Repairable vehicles may only be sold to licensed
automobile wreckers.)
I have inspected the vehicle herein described and to the best of my knowledge and information do hereby certify and
affirm the vehicle is NOT a Salvage, Flood Damaged, Total Loss, previously Rebuilt or Non-Repairable vehicle.
Was registered (current or expired) and the license plate number is __________________________.
Expiration date ___________________________ State _______________________
Date of Certified Mailing; __________ day of _______________ 20______.
*First Date of Newspaper Publication; __________ day of _______________ 20______.
Name of Newspaper ________________________________________________________________________________
Address__________________________________________________________________________________________
Address City State Zip Code
Public Auction Date; __________ day of _______________ 20______.
I hereby certify and affirm that all provisions of NRS 108.270 through 108.360 and 487.250 have been complied with, and
make this affidavit for the purpose of satisfying the Nevada Department of Motor Vehicles that a Registration Certificate
and/or Certificate of Title for the described vehicle should be issued to the purchaser upon the facts stated herein. I also
hereby release, discharge and agree to hold harmless the Nevada Department of Motor Vehicles of and from any and all
liability to anyone whomsoever which may arise by reason of any contest of the validity of the lien herein referred to, or the
validity of the sale under said lien, or failure of Lien Claimant to satisfy lien in the manner prescribed in NRS and NAC 108.
Printed Full Legal Name of Lien Claimant ____________________________________
State of Nevada, County of ________________________________
Subscribed and sworn to before me on _____________ By ____________________ _
Date Signature of Lien Claimant
_________________________________________
Notary Public or Authorized Nevada DMV Representative
Notary Stamp
Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed and witnessed.
NOTE: This document must be accompanied with a completed Vehicle Inspection Certificate (Form VP-15). If the lien
claimant is actively licensed through the department a completed Vehicle Inspection Certificate (Form VP-15) is not
required.
Definition of Types of Liens
Abandoned Vehicle means at the direction of any peace officer or with the release of a property owner who orders the
towing or storage of any vehicle
Keeper of a Trailer Park means a mobile home park, mobile home lot or other land for rental of spaces for trailers,
mobile homes or manufactured homes
Mechanics means a garage or place for the maintenance or repair of motor vehicles, motorcycles, motor equipment,
or trailers, including the operator of a salvage pool
Storage means the sum due for the storing, maintaining, or keeping of the motor vehicle, motorcycle, motor
equipment, or trailer
Tow means the sum due for the towing and storing of the motor vehicle, motorcycle, motor equipment, or trailer.
*Not required for abandoned vehicle with an appraised value under $500
