TENNESSEE DEPARTMENT OF REVENUE
SPECIAL INVESTIGATIONS - ANTI-THEFT UNIT
SURETY BOND APPLICATION
FOR OFFICE USE ONLY
BOND NO.
AMOUNT $
RE:
MAKE AND YEAR
VEHICLE IDENTIFICATION NO.
I REQUEST TO POST A SURETY BOND AS PROVIDED IN SECTION 55-3-103, T.C.A. THE CIRCUMSTANCES WHY
PROPER PAPERS CANNOT BE FURNISHED ARE:
MOTORCYCLE ENGINE NUMBER:
MOBILE HOME LENGTH AND WIDTH:
APPROXIMATE VALUE AT PRESENT TIME/
PRICE YOU WOULD ASK IF SELLING: $
NAME, ADDRESS, AND TELEPHONE NUMBER OF PERSON FROM WHOM PURCHASED:
NAME
ADDRESS
CITY STATE
ZIP CODE
TELEPHONE
NAME AND ADDRESS OF SURETIES SIGNING BOND WITH PRINCIPAL:
(1)
NAME OF PRINCIPAL:
PRINT OR TYPE
ADDRESS:
PRINT OR TYPE
CITY, STATE ZIP CODE:
PRINT OR TYPE
TELEPHONE NUMBER:
HOME
WORK
NOTE:
BONDS WILL NOT BE ISSUED ON VEHICLES THAT ARE NOT ROADWORTHY. CERTIFICATION OF IDENTIFICATION
NUMBER MUST ACCOMPANY THIS FORM. REQUESTS ON MOTORCYCLES MUST BE ACCOMPANIED WITH A PENCIL
TRACING OF BOTH THE FRAME AND ENGINE NUMBERS. SUBMIT ALL OWNERSHIP DOCUMENTS.
RV-F1313201 (Rev. 3-09)
ALL BONDS WILL BE BASED ON THE CURRENT NADA VALUE.
BOND REQUESTS SHOULD BE MAILED TO: TITLE AND REGISTRATION DIVISION, 44 VANTAGE WAY, SUITE 160,
NASHVILLE, TENNESSEE 37243-8050.
(2)
GENERAL CERTIFICATION FROM TRUSTEE, TAX ASSESSOR, BANKER, OR COUNTY CLERK, OF VALUE OF
PROPERTY OWNED BY THE TWO SURETIES:
(1)
(2)
