Fillable Title Revocation Affidavit for a First Sale (Texas Department of Motor Vehicles)

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Title Revocation Affidavit for a First Sale (Texas Department of Motor Vehicles)

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The Title Revocation Affidavit for a First Sale (Texas Department of Motor Vehicles) form is 1 page long and contains:

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  • 4 check-boxes
  • 27 other fields

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File type: PDF

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Title Revocation Affidavit for a First Sale
Vehicle Information
Vehicle Identification Number
Year
Make
Body Style
Model
Date of Sale
Purchaser in Possession After Sale?
☐
Yes, but was returned
☐
No, was never in possession of the purchaser
If Yes, Date Vehicle Was Returned
Purchaser Information
First Name (or Entity Name)
Middle Name
Last Name
Suffix (if any)
Additional Purchaser First Name (if applicable)
Middle Name
Last Name
Suffix (if any)
Address
City
State
Zip
Lienholder Information – if applicable
Lienholder Name
Address
City
State
Zip
Dealership Information
Dealership Name
Dealer License Number
Address
City
State
Zip
Odometer Disclosure Statement – complete only if purchaser was ever in possession of the vehicle
Federal and state law require that you state the mileage upon transfer of ownership. Providing a false statement or failure to complete this form may result in fines
and/or imprisonment. I, the purchaser listed above or their authorized agent, certify to the best of my knowledge the odometer reading is the actual mileage of the
vehicle unless one of the statements is checked:
Odometer Reading (no tenths)
☐ Mileage Exceeds Mechanical Limits
☐
Not Actual Mileage (WARNING – ODOMETER DISCREPANCY)
I am aware of the odometer certification made by the purchaser/agent.
Signature of Purchaser/Agent
Date
Signature of Dealership’s Authorized Agent
Date
Purchaser Acknowledgement
I, the purchaser listed above, or their authorized agent, certify the sale was cancelled and the statements herein are true and correct.
Signature(s) of Purchaser(s)/Authorized Agent
Printed Name(s) (Same as Signature(s))
Date
Lienholder Acknowledgement – if applicable
I, the authorized agent of the lienholder listed above, certify the sale was cancelled; the lienholder has no interest in the vehicle or the lien on the vehicle has been
satisfied; and the statements herein are true and correct.
Signature of Lienholder’s Authorized Agent
Printed Name (Same as Signature)
Date
Dealer Affidavit – State law makes falsifying information a third degree felony
I, the authorized agent of the dealer listed above, affirm I am employed by the licensed dealership that made a first sale of the new motor vehicle described
above on the date of sale listed, all parties involved in the sale have cancelled the sale, the purchaser(s) and lienholder(s), if applicable, have acknowledged the
statements herein, and the statements herein are true and correct.
Signature of Dealership’s Authorized Agent
Printed Name (Same as Signature)
Date
NOTARY
STAMP
HERE
Before me, a notary public, on this day personally appeared ,
known to me to be the person whose name is subscribed on this document, and being by me first duly
sworn, declared that the statements herein contained are true and correct.
State of Texas, County of
Notary Public’s Signature
Date
VTR-17 Rev 06/20 Form available online at www.TxDMV.gov Page 1 of 2
Title Revocation Affidavit for a First Sale
Information
This form may only be used to revoke the title application for a vehicle subject to a first sale on a manufacturer’s certificate of
origin (MCO). The affidavit must be completed and postal date stamped no later than 90 days after the date of sale.
Typically, a Texas title issues on the 7
th
calendar day following county processing. If the Texas Certificate of Title is issued prior to
the department receiving and/or processing this affidavit, the dealership will be responsible for obtaining and submitting the
original Texas Certificate of Title before the record will be revoked. However, if the Texas title is an electronic title held by a
lienholder, the lienholder is not required to release the title to the dealership.
If the vehicle was in the possession of the purchaser(s) after the sale, the revocation facilitated by this form does not negate the
fact that the vehicle has been subject to a previous retail sale. A vehicle subject to a first sale may have implications on peripheral
items related to the vehicle such as retail value and manufacturer’s warranties.
Instructions
Please complete this form in black or blue ink only.
1. The dealership must complete the
“Vehicle Information,” “Purchaser Information,” and “Dealership Information” sections.
Additionally, if there is a lienholder, the “Lienholder Information” section must also be completed.
2. The dealership must obtain an original signature from the purchaser(s) and any lienholder(s), if applicable, in the applicable
acknowledgement sections.
• The original signatures are not required on the same form. A separate form may be used for each purchaser and
lienholder, if applicable.
• A dealership may not use a power of attorney to complete this form on behalf of purchaser(s) or lienholder(s).
3. If the purchaser was ever in possession of the motor vehicle (“Yes, but was returned” is checked in the “Vehicle Information”
section), the purchaser must complete the “Odometer Disclosure Statement” section, and the dealership must acknowledge
this statement.
4. Once the dealership has obtained original signatures for each purchaser and lienholder, as applicable, the dealership must
complete the “Dealership Affidavit” before a notary public. If multiple forms are used, each form must contain an original
dealer affidavit and notary.
5. Once the form(s) have been notarized, the dealership must submit the following to the Texas Department of Motor Vehicles:
• Original, notarized Title Revocation Affidavit for a First Sale (Form VTR-17)
• Copy of the dealership’s motor vehicle dealer license
• The original Texas Certificate of Title (if the Texas Certificate of Title has already been issued)
6. Mailed to:
Texas Department of Motor Vehicles
Vehicle Titles and Registration Division
ATTN: Title Services
4000 Jackson Avenue
Austin, Texas 78731
7. An MCO that is surrendered to the county tax assessor-collector’s office cannot be returned. The dealership must obtain a
duplicate MCO in order to facilitate a subsequent transfer.
VTR-17 Rev 06/20 Form available online at www.TxDMV.gov Page 2 of 2
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Title Revocation Affidavit for a First Sale (Texas Department of Motor Vehicles)

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Completed 11 January 2022

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