Tennessee Department of Revenue
Taxpayer and Vehicle Services Division
POWER OF ATTORNEY FOR VEHICLE TRANSACTIONS
(Tenn. Code Ann. § 34-6-101 and 102)
DATE:
I
, do hereby appoint
(Name of Attorney-in-fact Representative)
of
(Name)
as my attorney-in-fact to sign my name to all
(City)
(State)
(Zip Code)
applicable documentation relative to any title or registration transactions for the vehicle described herein. I understand that these
documents may contain the federally mandated odometer disclosure and that I am responsible for the disclosures made therein. This
authority is
limited to the vehicle listed below:
Make
VIN
Model Body Type
Year
Check the appropriate box for each transaction type authorized:
Duplicate Title Transfer of Title
Noting of Lien Application for Title and Registration
Request for Verification of Ownership on Vehicles Other:
Found Abandoned, Immobile or Unattended (Specify)
Vehicle Information Request
The area below is to be completed by the party granting authority:
Individual
Business
Business Name
(Signature of Individual or Business Owner) (Printed Name of Individual or Business Owner)
(Physical Street Address)
(City) (State)
(Zip Code)
(Telephone Number)
(Email Address)
TO BE COMPLETED BY NOTARY:
STATE OF TENNESSEE County of
Personally appeared before me, the undersigned authority, , with whom I have
identified, who acknowledged that the foregoing instrument was executed for the purpose therein contained and I as a duly sworn
notary have verified that they are a legal resident of
County, Tennessee.
Please check the below document(s) used for verification:
Driver’s License Military ID
Birth Certificate Passport
State Issued ID Other (Specify)
(Notary Public)
My Commission Expires:
Date:
NOTE: This document is void if any information has been left blank or if any information entered hereon has been erased or
altered by any means.
RV-F1311401 (Rev. 11-08)
( )
(Business or Title Service, if applicable)
(Street Address)
Dealers must use a secure power of attorney (RV-F1316901) to transfer ownership when the original certificate of title is not
available for the owner to make an odometer disclosure as required by The Motor Vehicle Information & Cost Savings Act of 1986;
49CFR580.
