Fillable Mv2117 Repossession Application

Fill Online, Printable, Fillable, Blank Mv2117 Repossession Application Form

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

Mv2117 Repossession Application

On average this form takes 13 minutes to complete

The Mv2117 Repossession Application form is 2 pages long and contains:

  • 0 signatures
  • 8 check-boxes
  • 50 other fields

Country of origin: US
File type: PDF

BROWSE WISCONSIN 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
 
REPOSSESSION
APPLICATION
MV2117 10/2019
s.409.105(H) Wis. Stats.
Title No. – New License Plate No.
Amount Received – Document No.
Check Cash
Fee $164.50
SUBMIT TO:
Wisconsin Department of Transportation
P.O. Box 7949, Madison, WI 53707-7949
Section A
The Secured Party Legal Business Name and address listed on this form must match DMV records.
Vehicle Identification Number (standard VIN has 17 characters)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Vehicle Make
Vehicle Model Year
Vehicle Body Style
SECURED PARTY – Legal Business Name (please print)
Secured Party Number
1
2
3
4
5
6
7
8
(Area Code) Telephone Number
between 7:30 a.m. and 4:30 p.m.
SECURED PARTY – Social Security Number
–
–
1
2
3
4
5
6
7
8
9
OR
Driver License Number
–
–
1
2
3
4
5
6
7
8
9
10
11
12
13
14
OR
FEIN Number
–
1
2
3
4
5
6
7
8
9
SECURED PARTY – Street Address
City
State
Zip Code
SECURED PARTY – Special Mailing Street Address
P.O. Box (if applicable)
City
State
Zip Code
REPOSSESSED FROM – Legal Name (please print)
Date Repossessed
Security Agreement Date
Repossessed in State of
Notice of Sale given
to subordinate
lienholders
REPOSSESSED FROM – Street Address
City
State
Zip Code
I (we) certify that the above described vehicle was repossessed in the state of and under security agreement as indicated above in compliance with the
provisions of the Wisconsin Uniform Commercial Code, s.342.18(2) and 342.19(5), Wisconsin Statutes, and the Wisconsin Consumer Act as amended
when applicable. (See s.425.201 through 425.210).
I (we) further certify that this vehicle has been sold in compliance with said security agreement, the Wisconsin Uniform Commercial Code and the
Wisconsin Consumer Act when applicable to:
BUYER – Legal Name
If buyer/dealer at sale is other than
repossessor, the buyer/dealer must
complete and submit form MV1,
Application for Title/Registration, with
this document.
BUYER – Street Address
City
State
Zip Code
BUYER – Mailing Address
P.O. Box
City
State
Zip Code
ODOMETER MILEAGE STATEMENT
Federal and State law require that you state the mileage in connection with the transfer of ownership. Failure to complete a mileage statement or
providing a false statement may result in fines and/or imprisonment and may make you liable for damages to your transferee (buyer).
I, the repossessor, certify that to the best of my knowledge the information contained on this document is true and correct and that the
ODOMETER NOW READS (no Tenths):
.
X
and to the best of my knowledge is actual mileage of this vehicle unless one of the
following statements is checked:
The odometer reading reflects the amount of mileage in excess of its mechanical limits.
The odometer reading is NOT the actual mileage – WARNING ODOMETER DISCREPANCY.
BRAND DISCLOSURE STATEMENT will be printed on future titles. Check all that apply.
Flood Damaged Hail Damaged Salvage Vehicle
Previous Taxicab Previous Police Vehicle
(Print Name of Buyer Signing Below) (Print Name of Repossessor Signing Below)
X X
(Signature of Buyer) (Date) (Signature of Repossessor or Authorized Agent) (Date)
Complete section "B" on reverse side when vehicle has been Complete section "C" on reverse side when vehicle
repossessed by someone other than secured party shown above. has been repossessed outside Wisconsin.
REPOSSESSOR STATEMENT
pursuant to s.421.201(5) Wis. Stats.
Section B
Repossessor (If different from that information shown in section “A”)
Legal Name (please print)
County
Street Address
City
State
Zip Code
Section C
Repossession (If vehicle repossessed outside of Wisconsin)
Repossessed in State of
Per Laws of State of (State that repossession authorization originated)
Current Vehicle Location (City, County, State)
Number of Days at Location Indicated
I certify that:
1. As repossessor I was employed by the identified secured party in section “A”;
2. The person identified as “Repossessed From”, section “A”, who is incorporated by reference,
was a resident of Wisconsin at the time of execution of the security agreement and removed
the above identified vehicle from Wisconsin for a period in excess of 15 days;
3. The information on this statement is true and correct to the best of my knowledge;
4. This statement is in support of a request for retitling the vehicle identified on reverse side.
X
(Repossessor/Authorized Agent Signature)
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

Mv2117 Repossession Application

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 10 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document