TR-134 (Rev. 0616)
Kansas Department of Revenue
Authorization to Receive Title
Please Check Appropriate Box
Individual Authorization: Dealer Authorization
Individual authorizing a Dealership Dealer authorizing an Individual
Individual authorizing at Title Service Dealer authorizing a Title Service
Individual authorizing an Individual
Vehicle Information: (Required if a box under Individual Authorization is checked)
Vehicle Identification Number
Authorizing Agent information:
Name of all Owner(s) as shown on the title:
Name of Dealership: Dealer Number:
Name of Title Service: Title Service No.:
Name of Individual: Driver’s License #:
As the owner of the vehicle, I authorize the above individual, dealership or title service to act as the authorized agent
to present a title application, accept delivery of the original or duplicate title and any lien releases for vehicles traded
into the dealership.
Signature of Owner(s): Date:
Printed Name of Owner(s):
If the authorized agent is a dealership or title service, it is understood that we are responsible for notifying the
division, or any of its agents, if this authorization is revoked or canceled.
Signature Authorized Agent: Date:
Printed Name of Agent/Individual:
Any cross outs, whiteout, or alterations void this form.
Check the appropriate box and complete ALL information. If any field is left blank/incomplete, the
form is void.
When the authorizing agent is an individual, this form is only valid for the vehicle listed herein.
This form becomes a supporting document for the application for which it is being executed. The
original cannot be returned. Incomplete forms will be kept by the division but will not be valid for
Only the original of this form is valid. Copies of the completed form will not be accepted.
All Requirements Subject to Change without Notice. The web site, www.ksrevenue.org will have
the most up to date forms and requirements.