TITLE APPLICATION BRANDING NOTIFICATION (continued)
Wisconsin Department of Transportation MV2849 s.340.01(18p), s.340.01(20m), s.340.01(55g), s.342.06, 342.065(1)(c), 342.065(1m) Wis. Stats.
Title Only – Transfer title to insurance company. (See reverse for owner retention.)
The insurer listed in Section C of this form is applying for title to the vehicle listed in Section A. By obtaining a title only without
registration, operation of the vehicle is not permitted upon public highways. If applying for registration (non-salvage vehicle only) or
adding a lien, submit form MV1, Title and License Plate Application, and applicable fees with this form.
Check all applicable brands from the list below.
Salvage - The vehicle is less than 7 years old and was damaged to the extent that the estimated or actual repair cost, whichever
is greater, exceeds 70% of its fair market value.
Flood Damage - The vehicle was damaged by flood to the extent that the estimated or actual repair cost, whichever is greater,
exceeds 70% of its fair market value.
Hail Damage - The vehicle is less than 7 years old and was damaged by hail to the extent that the estimated or actual repair cost,
whichever is greater, exceeds 70% of its fair market value.
Insurance Claim Paid - The vehicle is less than 7 years old and was transferred to the insurer upon payment of a claim for
damages of 30% through 70% of its fair market value.
To apply for title in insurance company’s name, submit:
The current title, with the odometer information completed and signed by all required previous owners in the reassignment area
Lien release for any lien listed on the vehicle title or electronic vehicle record
$164.50 title transfer fee; $5.00 counter service fee (if applying in person at DMV Customer Service Center)
Make check payable to: Registration Fee Trust
Previous owner does not execute assignment and warranty of title. Applies only to salvage title.
An insurer taking delivery in Wisconsin of a salvage vehicle that is not currently titled as salvage upon payment of an insurance claim
that, including any deductible amounts, exceeds 70 percent of the fair market value of the vehicle, may submit the following in lieu of
the title:
Completed and signed MV2488, Vehicle Transfer and Odometer Mileage Statement, showing vehicle odometer reading
Copy of proof that the insurer has paid the owner or secured party a total loss claim that exceeds 70 percent of the fair market
value of the vehicle
Signed acknowledgement below of the following affidavit:
I have provided notice to the previous owner of the requirement under s.342.15(1)(c) to execute an assignment and warranty of
title for the .
Year Make Vehicle Identification Number
Notice was provided concurrently with the payment of the claim or by certified mail or electronic means. The previous owner did not
execute an assignment and warranty of title for the vehicle to me, the insurer, within 30 days of receiving the notice.
I have on at least 2 occasions requested in writing addressed to the previous owner and secured parties that the previous owner
execute an assignment and warranty of title for the vehicle to me. These requests were addressed to the previous owner and secured
parties and were sent by certified mail or electronic means, including electronic mail or posting on an electronic network or site that is
accessible via the Internet by using a mobile application, computer, mobile device, tablet, or any other electronic device.
Name of owner notified:
Names of secured parties notified:
Mail to: Wisconsin Department of Transportation
P.O. Box 7949
Madison, WI 53707-7979 I certify the information on this application is true and correct.
X X
(Insurance Company Authorized Agent - Print Name) (Insurance Company Authorized Agent Signature) (Date)
