Fillable STATE OF WYOMING Application for Certificate of Title

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STATE OF WYOMING Application for Certificate of Title

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STATE OF WYOMING
Application for Certificate of Title and VIN/HIN Inspection Form
(Proof of ownership MUST accompany application)
PURCHASER / SELLER INFORMATION
(Please print clearly)
NAME OF PURCHASER(S)
Joint Tenants
With Rights of
Survivorship?
ADDRESS CITY STATE ZIP
NAME OF SELLER
ADDRESS CITY STATE ZIP
LIEN INFORMATION (Please print clearly)
NAME OF LIEN HOLDER
ADDRESS CITY STATE ZIP
LIEN FILING # FILING DATE LIEN AMOUNT
I/WE HEREBY SWEAR OR AFFIRM under penalty of perjury that all information on this application is true and correct and that I/we am/are lawfully applying for
a Wyoming Certificate of Title. I/we further warrant that said vehicle is owned by me/us and is subject to the liens shown and none other. I/we further certify to the
best of my/our knowledge that if the vehicle is a mobile home, all taxes due on the mobile home for the preceding and current year have been paid and in the event
taxes have not been paid, acknowledge that I/we may be responsible for the taxes for the preceding and current year. Any false information may cancel the title
and void any registration associated with the title.
PURCHASER SIGNATURE(S): X X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~“V I N” or “H I N” Inspection Form~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
REQUIRED WHEN THE PRIOR TITLE IS FROM A STATE OTHER THAN WYOMING. NOT REQUIRED FOR MSO/MCO.
** Before completing the V.I.N. or H.I.N. inspection, please review the “NOTICE” on the reverse side or this form to determine if you are authorized by
statute to do so. Please print the vehicle/watercraft information as accurate and legible as possible and then verify with your signature at the bottom.
AUTHORIZED AGENT
PRINT VIN OR HIN HERE ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____
Vehicle Identification Number (VIN) typically contain 17 alpha-numeric characters and
Hull ID Number (HIN) HIN’s are required to have 10-14 but typically have 12 alpha-numeric digits, with no spaces or dashes.
Year: Make: Model: Trim: VIN / HIN Verified With NCIC? Yes / No
(Ford, Jeep, Chevy, Honda, etc.) (F-150, Camaro, Wrangler, etc.) (XLT, Lariat, GT, LS, Rubicon, etc.) (Circle One)
Subject to the penalties of perjury, I, BADGE/TITLE/DLR NUMBER: am
an authorized member or employee of, AGENCY or ENTITY NAME:
(Please Circle One) Police Dept. / Sheriff’s Office / Highway Patrol / State Police / G&F / Other Entity:
depose and state that, I personally inspected the VIN or HIN in the state of on the above described vehicle/watercraft and the information entered by
me is true and correct. The undersigned verifies that I am authorized by the laws of Wyoming (or state where the inspection occurred), to conduct this inspection.
Signature:
Date: Phone:
W.S. 31-3-102(b) provides a $10.00 fee for each vehicle identification number inspected, and one $10.00 fee for inspection of a VIN and HIN at the same time, pursuant to W.S. 31-2-103(a)(vi).
MV-300A (01/20)
Motor Vehicle Traile
r
Snowmobile Watercraft Mobile Home Date Title Issued:
MANUFACTURER
Y
EAR
V
EHICLE / HULL IDENTIFICATION NO. NMVTIS BODY STYLE
FACTORY PRICE /
MSRP
STATE PRIOR TITLE NO. ODOMETER WEIGHT PURCHASE DATE
V
ESSEL LENGTH
BRANDED TITLE INFORMATION –definitions and requirements are on the reverse side of this application.
Does this motor vehicle currently have or ever had a branded title? Yes No If Yes, what title brand?
Has this motor vehicle been declared a total loss by an insurance company or sustained 75% damage of actual cash value? Yes No
Printed Name of Person Completing this Section: Signature:
X
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NOTICE: The person conducting the VIN (vehicle) or HIN (watercraft) identification number inspection SHALL be authorized by
their state statute regarding inspections of this nature. Any person who conducts a VIN or HIN inspection and is not lawfully
authorized to do so shall be cause to void the title application and may void any title or registration issued that is related to this
VIN or HIN inspection. In addition, YOU MAY BE SUBJECT TO CRIMINAL PENALTIES. (A VALID HIN on a watercraft is
required to have 10-14 alpha-numeric digits but typically has 12, with no spaces or dashes.)
Wyoming V.I.N. Inspection Statutes
W.S. 31-2-103. Contents of application; signature; vehicle identification number; issuance of certificate.
(a) (vi) In the case of a vehicle
r
egistered or titled in a state other than Wyoming, or any
homemade vehicle, rebuilt vehicle, reconstructed vehicle, any vehicle assembled from a kit or any vehicle
for which a bond is required, a current statement made by a Wyoming law enforcement officer, or licensed
Wyoming dealer only for vehicles in his inventory or possession, that the vehicle identification number on
the vehicle has been inspected and that the inspection occurred in Wyoming and certifying the correct vehicle
identification number displayed on the vehicle. Any licensed Wyoming dealer performing an inspection of a
vehicle identification number under this section shall, in addition to the requirements of this act, do so
pursuant to W.S. 31-11-108. In the case of a vehicle not in Wyoming, the vehicle identification number may
be inspected and certified on a form approved by the department if the inspection is made by an
authorized law enforcement officer of a city, county or state law enforcement agency or a commissioned
officer at a federal military installation or any other person authorized to do so by law
a
nd delivered
to the county clerk in the county where the application for certificate of title is made along with payment
for the inspection fee required under W.S. 31-3-102(b)(iv);
(ix) Such other information as required by the department or county clerk which may include but
not be limited to a vehicle bill of sale or similar document, any documentation necessary to verify proof of
ownership including an affidavit for proof of ownership or any surety bond required by this act. Any
affidavit for proof of ownership shall be prescribed pursuant to W.S. 31-1-201(d) and shall be utilized by
each county of this state;
(x) A Wyoming certificate of title shall contain an appropriate notice whenever records readily
accessible to the state indicate that the motor vehicle was previously issued a title or registration from
any jurisdiction that bore any word or symbol signifying that the vehicle was "salvage", "unrebuildable",
"parts only", "scrap", "junk", "nonrepairable", "reconstructed", "rebuilt" or any other symbol or word of
like kind, or that it has been damaged by flood.
ny information concerning a motor vehicle's status
shall also be conveyed on any subsequent title issued for the vehicle by this state, including a duplicate
or replacement title.
(d) Upon receipt of an application and payment of fees any county clerk shall, if satisfied that
the applicant is the owner of the vehicle for which application for certificate of title is made, issue a
paper certificate of title or electronic certificate of title, if available, upon a form or electronic
format, approved by and provided at cost to the county clerk by the department in the name of the owner
bearing the signature and seal of the county clerk's office. The county clerk shall not deliver a certificate
of title issued under this section until presentation of a receipt for payment of sales or use tax pursuant
to W.S. 39-15-107(b) or 39-16-107(b).
Wyoming Salvage Statute Information
W.S. 31-2-107. Titles for damaged vehicles; return of certificate of title and registration for
damaged vehicle; replacement title and registration.
(a) When a motor vehicle is declared a total loss by the insurance company or, in the event an
insurance company is not involved in the settlement of the claim, sustains damage in an amount exceeding
seventy-five percent (75%) of its actual retail cash value, as set forth in any current edition of a
nationally recognized automotive appraisal guide or other source approved by the Wyoming insurance department,
the owner or insurance company, if it obtains ownership of the vehicle through transfer of title as a result
of a settlement of an insurance claim, shall forward the properly endorsed certificate of title to the
office of the county clerk that issued the certificate of title together with an application for a
certificate of title branded salvage and payment of the fee required under W.S.
31-3-102(a)(vii) to obtain a properly branded certificate of title. When any vehicle accident report
is required under chapter 5, article 11 of this title, the investigating officer shall provide written
notice to the owner or operator of the vehicle of the requirements under this section.
(d) This section shall not apply to motor vehicles with more than eight (8) years of service except
any vehicle that was previously issued a title from any state that bore any word or symbol signifying that
the vehicle was "salvage", "unrebuildable", "parts only", "scrap", "junk", "nonrepairable", "reconstructed",
"rebuilt" or any other symbol or word of like kind, or that it has been damaged by flood, shall obtain a
Wyoming title with the prior brand or any other information concerning the motor vehicle status, carried
forward on any subsequent Wyoming title regardless of years of service.
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STATE OF WYOMING Application for Certificate of Title

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Completed 14 May 2022

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