LB-063
NOTIFICATION OF ASSIGNMENT, RELEASE OR GRANT
OF SECURED INTEREST
Grant: The name of the secured party being added is entered in Section A. The party in possession of the Certificate of
Title must attach this form to the certificate.
Release: This form is to be completed within 15 days after satisfaction of a subordinate security agreement. Enter the
subordinate secured party name and address in Section A. This form is sent to the owner who delivers it to the first
secured party who is in possession of the Certificate of Title. Attach the form to the Title and deliver to the Department of
Natural Resources or the nearest Deputy Registrars office.
Assignment: The assignor must be named either on the application for Certificate of Title or on the Title to assign their
interest. The name and address of the assignee are entered in Section B. If the assignor does not have the Certificate of
Title in their possession, they must deliver the assignment to the secured party possessing the Title who forwards the Title
and assignment to the Department of Natural Resources. For an assignment noted concurrently with the secured interest,
the assignment accompanies the granting of a secured interest.
Year Make Model Registration Number
Hull Identification Number Title Number
Owner Name
Address City State Zip Code
Signature of Owner (Necessary only With Grant)
Secured Party Name MN Tax Id No. Assignee Name (Assignments Only)
Address Address
City State Zip Code City State Zip Code
Section A
Signature and Title of Authorized Agent
Section B
MN Tax ID No.
GRANT: The owner (s) have granted to the secured party named in section A, a secured interest in the watercraft
described above. Date and time of security agreement: _______________________
AM PM
RELEASE: The secured party named in section A no longer claims a security interest in the watercraft described
above.
Date of release: _________________
ASSIGNMENT: The secured party named in section A has assigned their interest to the secured party in section B.
Please mail
application and required documentation (if any) to:
Brainerd License Office
623 NW 4th St
Brainerd MN 56401
2188555169
October 7, 2008
