Michigan Department of State
Notice of Rejection of Vehicle Financing
Year Make VIN
Dealer Name City Street Address State Zip code
Name City Street Address State Zip code
Original Secured Party
(Shown on Dealer's RD-108 Title Application)
Name City State Street Address Zip code Date of Original Lien
Representing the original secured party listed above which was shown on the purchaser's RD-108 application for title for this vehicle, I certify the loan agreement was not accepted. I further certify the secured party identified above has no financial interest in this vehicle and the selling dealer may assume our security interest and the Retail Installment Sale Contract.
Signature Printed Name Position
Completion of this form by the security party originally shown on dealer's title application constitutes release of financial interest. A separate lien termination statement is not required. The selling dealer assumes the loan and submits this form, the outstanding title (if available), standard title fee, and a correction title application showing the dealer as the new lienholder. The vehicle purchaser's signature is not required. A corrected title showing the dealer as the new lienholder will be mailed to the vehicle owner.
Authority granted under P.A. 300 of 1949 as amended.