Request for Title Hearing
Please type or print legibly.
Applicant Information
Name of Person or Business (as it will appear on the title):
Phone: County of Residence: Email:
I (we) hereby request the Tax Assessor-Collector grant a hearing for the purpose of establishing the ownership of
the following described vehicle:
Vehicle Information
V
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hi
c
l
e
I
nfo
rmat
ion
N
umb
er:
Year: Make:
Body Style: ________________Plate Number: ____________ Color: ___________ Odometer: ___________
I (we) make the following statement of facts in regard to ownership of the vehicle described above:
I purchased the vehicle from:_______________________________________ Date of Purchase: ___________
Purchase Price: $ _____________
Reason for Requesting a Title Hearing:
(Please explain in detail.)
List all the proof available for the use of the Tax Assessor-Collector in determining the status of your title hearing.
I (we) have been denied by the Texas Department of Motor Vehicles and have been unable to secure title through
normal procedures. Therefore, this request is made as provided by the Texas Certificate of Title Act.
______________________________ ________________________________________ ________________
Signature of owner/agent Printed name owner/agent Date
If the application is on behalf of a company, such application must be executed by an officer and properly notarized. Any person
signing on behalf of an organization must present adequate proof of authorization to act on behalf of the organization:
Subscribed
and
sworn
to
me
this
day
of ,
Notary Publi
c or Harris County Deputy
WARNING: Fa
lsifying information on any required statement or government document is a criminal offense and is
punishable by fine and/or imprisonment.
MV-146A www.hctax.net Rev. 7/18 v4
FOR OFFICE USE ONLY
Clerk:
Date Received:
ANN HARRIS BENNETT
Tax Assessor-Colle
ctor &.
Voter.Registrar
