MVR-4 online (Rev. 05/18) North Carolina Division of Motor Vehicles
$20.00
Fee
There is a 15-day mandatory waiting period after an application for duplicate title is received by the Division of Motor
Vehicles before a certificate of title can be issued. Mail to: NCDMV, 3148 Mail Service Center, Raleigh, NC 27697-3148.
The
duplicate title will be issued subject to such liens as were recorded on the last title and mailed to the first lien holder of record, unless lien release is submitted.
The lien holder may apply for a duplicate title, without the signature(s) of the registered owner(s), if the original title was lost while in the lien holder’s possession.
When a title, mailed to a lien holder by the Division of Motor Vehicles, is not received, affidavits by the registered owner(s) and lien holder(s) are required in order to
obtain a duplicate title.
VEHICLE DESCRIPTION Title No.__________________________________________
Year ________________ Make ______________________ Body Style___________________ Series Model __________________________
Vehicle Identification Number ____________________________________________________________ Fuel Type ____________________
Name of Registered Owner(s) __________________________________________________________________________________________________________
First Name Middle Name Last Name
___________________________________________________________________________________________________________________________________
Residential Address City State Zip Code County
Mailing Address _____________________________________________________________________________________________________________________
(IF DIFFERENT FROM ABOVE)
Vehicle Location Address _____________________________________________________________________________________________________________
(IF DIFFERENT FROM ABOVE)
LIEN RECORD AS SHOWN ON ORIGINAL TITLE
First Lien __________________________________________________________________________________________________________________________
Date Lien Holder Address
Second Lien ________________________________________________________________________________________________________________________
Date Lien Holder Address
Third Lien __________________________________________________________________________________________________________________________
Date
Lien Holder Address
DISCLOSURE SECTION
All motor vehicle records maintained by the North Carolina Division of Motor Vehicles will remain closed for marketing and solicitation unless the block below is
checked.
I (We) would like the personal information contained in this application to be available for disclosure.
CHECK APPLICABLE BLOCK
Application for Duplicate Certificate of Title and Assignment by Registered Owner
Application for Duplicate Certificate of Title as Recorded
Application for Duplicate Certificate of Title and Removal of Lien
If original title was issued subject to a lien and it has been satisfied, lien holder must certify to that effect.
I (we), the registered owner(s) of the above described vehicle, hereby make application for a duplicate certificate of title and certify that the original has been:
(Check applicable block)
Lost Never Received
I understand that upon issuance of the duplicate, the original title becomes void and that I am required to return the original title to the Division of Motor Vehicles
immediately should it be found.
Current Odometer Reading
I (we) certify that the information on the application is correct to the best of my (our) knowledge.
Signature(s) of registered owner(s) _____________________________________________________________________________________________________
Date____________________________ County __________________________________________ State __________________________________________
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document
for the purpose stated therein and in the capacity indicated: ______________________________________________________________(name(s) of principal(s)).
Notary Notary Printed
Signature______________________________________________________________ or Typed Name ____________________________________________
(SEAL) My Commission Expires ____________________________________
AFFIDAVIT OF FIRST LIEN HOLDER
I (we), support the application for a duplicate certificate of title covering the above described vehicle and certify that the original title was:
(CHECK APPLICABLE BLOCK) Title lost while in my possession; lien has been satisfied Lost while in my possession
Never Received Surrendered to _________________________________________________ upon payment of lien in full.
Lien holder’s signature by: ______________________________________________________________________________________________
Date ______________________________ County ________________________________________ State ___________________________________________
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document
for the purpose stated therein and in the capacity indicated: ______________________________________________________________(name(s) of principal(s)).
Notary Notary Printed
Signature______________________________________________________________ or Typed Name ____________________________________________
(SEAL) My Commission Expires ____________________________________
