ALABAMA DEPARTMENT OF REVENUE
MOTOR VEHICLE DIVISION
TITLE SECTION
P.O. Box 327640 • Montgomery, AL 36132-7640 • titles@revenue.alabama.gov
www.revenue.alabama.gov/motorvehicle/forms.html
Application For Lien Release
VEHICLE MUST BE CURRENTLY TITLED IN THE STATE OF ALABAMA
This form must be completed by the lienholder, accompanied by the certificate of title or
application for replacement certificate of title, and mailed to the address listed above.
LIEN INFORMATION – FELONY OFFENSE FOR FAILURE TO NAME LIENHOLDER WITH INTENT TO DEFRAUD
NAME OF FIRST LIENHOLDER
NAME OF SECOND LIENHOLDER
VEHICLE / MANUFACTURED HOME IDENTIFICATION NUMBER
– All VINs for 1981 and subsequent year model vehicles that conform to federal anti-theft standards are required to have 17 digits/characters.
MAKE: __________ YEAR: ________ MODEL: ___________
VEHICLE OR MANUFACTURED HOME IDENTIFICATION NUMBER
COMPLETE ONLY IF MULTIPLE SECTIONS
MAKE: __________ YEAR: ________ MODEL: ___________
MANUFACTURED HOME IDENTIFICATION NUMBER
COMPLETE ONLY IF MULTIPLE SECTIONS
MAKE: __________ YEAR: ________ MODEL: ___________
MANUFACTURED HOME IDENTIFICATION NUMBER
COMPLETE ONLY IF MULTIPLE SECTIONS
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MAKE: __________ YEAR: ________ MODEL: ___________ |
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MANUFACTURED HOME IDENTIFICATION NUMBER |
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OWNER INFORMATION – The name of the owner(s) with whom the lienholder held a security agreement. FELONY OFFENSE FOR FALSE ADDRESS. |
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NAME(S) (LAST NAME, FIRST, MIDDLE) |
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CURRENT MAILING ADDRESS |
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CITY |
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STATE |
ZIP |
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LIEN RELEASE INFORMATION |
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DATE OF LIEN RELEASE: ______________________________
SIGNATURES
The lien recorded on the original certificate of title is hereby released. The lienholder hereby certifies that the above information is true and correct and the lienholder is aware that a false statement made on this document, with intent to defraud, is a criminal offense under the Alabama Uniform Certificate of Title and Antitheft Law as codified in Title 32, Chapter 8, CODE OF ALABAMA 1975.
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SIGNATURE OF AUTHORIZED REPRESENTATIVE
Sworn to and
subscribed before me, ________________________________________
NAME OF NOTARY PUBLIC – MUST BE TYPED OR PRINTED
this ______ day of _________________, _______
Notary Public Signature: ________________________________________
NOTE: NO FEE IS REQUIRED TO BE SUBMITTED WITH THIS FORM.