![]() I certify that the information I have given on this application is true to the best of my knowledge and belief. ![]() If lost or destroyed, I do not know where it is if damaged, I have enclosed it with this application. I certify that the Certificate of Title for the vehicle, boat or manufactured home described above, and last issued in the owner's name, has been lost, destroyed or damaged. Number State / Daytime Telephone Number ( ) Zip Code SECTION 2 - CERTIFICATION I understand that the DUPLICATE CERTIFICATE OF TITLE that I will receive as a result of this application replaces all previously issued titles, and that only this duplicate title may be used to sell, transfer or trade the above vehicle, boat or manufactured home. È Vehicle or Hull Identification Number (VIN or HIN) Owner's Name (Last, First, M.I.) Date of Birth (Month/Day/Year) / C/O (applies if Power of Attorney or dealer authorization is shown or the owner is deceased) Current Mailing Address (Number and Street) City Apt. For more information visit È SECTION 1 CUSTOMER MUST COMPLETE SECTIONS 1 and 2 BELOW Year Make License Plate No. OR If your address has not changed since you last registered the vehicle and your current address is on your registration, you can apply for a duplicate title on-line. Pay with a check or money order payable to "Commissioner of Motor Vehicles", do not mail cash. OR Mail this application with PHOTOCOPIES of your proof of identity, any additional documentation (if required under Section 4) and the correct fee to the Title Bureau at the address shown on the top of this page. If Section 4 applies to you, bring the required documentation. u u Bring this application with your ORIGINAL proof of identity documents and the correct fee to any Motor Vehicles office. Provide a separate $20 fee for each application. If your name has changed, the owner is deceased, or if you have Power of Attorney, provide the required documentation that is described in Section 4 on page 2. Provide the required proof of identity for the person who signs the certification in Section 2 (see Section 3 on page 2). Read, sign and enter the date in Section 2 - Certification. (Photocopies are not accepted.) INSTRUCTIONS: u u u u Complete Section 1 below. o Included with this application is an original LIEN RELEASE that is signed and includes a date. If there is no statement that applies, go to "Instructions" below: Last, First, Middle Initial o The address is a NEW ADDRESS. APPLICATION FOR DUPLICATE TITLE TITLE BUREAU PO Box 2750 Albany NY 12220-0750 If any of the statements below apply to this application, mark the box of each statement that applies and complete Section 1 and Section 2 below.
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