Free Application For Utah Duplicate Title, TC-123 - Utah

Division of Motor Vehicles UTAH STATE TAX COMMISSION
210 North 1950 West Salt Lake City, Utah 84134 Telephone (801) 297-7780 or 1-800-DMV-UTAH

Clear form

Application For Utah Duplicate Title $6.00 Fee Required
Owner Information
Primary Owner's Name Last, First, Middle Initial

Address Information
Street Address

Secondary Owner's Name Last, First, Middle Initial

City

State

ZIP Code

Business Name

FEIN

P.O. Box

Fleet Number

Unit Number

City

State

ZIP Code

VIN/HIN

Year

Make

Model

I/We certify that the original certificate of title for this vehicle has not been endorsed and delivered to a transferee or delivered to a lending institution and/or pledged as collateral. I/We hereby make application for a duplicate certificate of title in lieu of the certificate that was lost, stolen, mutilated, or illegible, and agree to indemnify the Utah State Tax Commission and all persons acting under its direction from any and all liability and shall defend, at my/our expense, all litigation which may arise as a result of the issuance of the duplicate certificate of title. Owner/Applicant's Signature Date Owner/Applicant's Signature Date

Lien Holder Information
Lienholder of Record Name Address City State ZIP Code

Lien Release Section
Signature of lien holder (of record) releasing interest: Title Date

Assignment and Release of Interest Section Odometer Disclosure Required Reflects the actual mileage for this vehicle
Reflects the amount of mileage in excess of the odometer mechanical limits Enter mileage, no tenths Is not the actual mileage for this vehicle Warning - Odometer discrepancy Sale Price $ Date of Sale

Sales Purchase Price - Required
Print name of seller

Current address of seller (street, city, state, and ZIP Code) As owner(s), I/We hereby transfer all rights, title, and interest to this vehicle to the new owner named below. I/We certify to the best of my/our knowledge, that the title is free and clear of encumbrances, except the lien to the new lien holder, if any. I/We certify that the odometer and sales information provided is correct. Federal and state law require: 1) the owner provide the mileage upon transfer of ownership of a vehicle; and, 2) the owner must disclose any brand information recorded on the last Certificate of Title. Owner/Applicant's (and joint owner/applicant's) signature for transferring ownership Date

New Owner's Section
Name

New Lien Holders Section
Name

Address

Address

City

State

ZIP Code

City

State Date

ZIP Code

Signature of new owner(s)

Signature of new owner

Date TC-123 Rev. 10/04