Vehicle Application For Utah Title Utah State Tax Commission

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Utah State Tax Commission
TC-656
Rev. 9/13
Vehicle Application For Utah Title
Get forms online - tax.utah.gov
Division of Motor Vehicles · PO Box 30412, Salt Lake City, UT 84130 · Telephone 801-297-7780 or 1-800-368-8824
New
Change of
ownership
Change of
lienholder
Non-repairable title
Salvage title
Corrected title
Section 1 - New Owner Name Information
Primary owner’s driver license no. or
FEIN, if business
Dismantling permit
And
Relationship to co-owner:
DL state Co-owner’s date of birth
DL state Primary owner’s date of birth Co-owner’s driver license no. or
FEIN, if business
Primary owner’s name (last, first, middle initial, or business name)
Co-owner’s name (if at different street address, check here
Street address (primary owner)
City
State
ZIP code
Mailing address, if different from Street Address (primary owner)
City
State
ZIP code
Section 2 - New Lessee Information
and list on back)
And
Relationship to co-lessee:
DL state Lessee’s date of birth
Lessee’s driver license no. or
FEIN, if business
Or
Or
DL state Co-lessee’s date of birth
Co-lessee’s driver license no. or
FEIN, if business
Lessee’s name (last, first, middle initial, or business name)
Co-lessee’s name (if at different street address, check here
Street address (primary lessee)
City
State
ZIP code
Mailing address, if different from street address (primary lessee)
City
State
ZIP code
and list on back)
Section 3 - Vehicle Information (Missing or incorrect information may result in a rejected application)
Year
Passenger, light truck, van, or utility
Street motorcycle
Make
Model
Farm use? (Y/N)
Cylinders Fuel type
Vehicle Identification Number (VIN)
Small motor vehicles (CC______ HP______)
Off-highway vehicle (check one:
ATV
Unit number
Fleet number
Color
Motor home (length: ft______ in ______) (Class______)
Motorcycle)
Body type (trailers)
If branded title, brand type
Low-speed vehicle
Manufacturer's Suggested Retail Price
Purchase price
Snowmobile
$
$
Street-legal ATV
Manufactured housing
Odometer Disclosure
Heavy truck (registered weight _________________)
If this is a commercial vehicle, with a registered weight
of 10,001 lbs and greater, you must provide your
USDOT number: __________________________
Tent trailer
Travel trailer
Utility trailer
Section 4 - Registration Information
I certify that the odometer reading: (check one)
Reflects actual mileage for this vehicle
Reflects the mileage in excess of the odometer’s mechanical limits
Enter odometer reading (no tenths)
Other trailer: _____________________
Contribute $2 to:
Is not the actual mileage. Warning - Odometer Discrepancy
Enter length of trailer selected: ft______ in ______
ATV-Off Highway Fund
Friends For Sight
Organ Donation Support
License Plate Type - Life Elevated Arches plates will be issued unless otherwise indicated. For a new personalized plate, complete TC-817. Additional fees will apply.
Title only
Life Elevated Arches
Life Elevated Skier
Situs/physical address of vehicle, if different from street address above
Transfer: _________________
City
Other: __________________________
ZIP code
State
Section 5 - Lien Holder Information
Lien holder’s name
FEIN or driver license no., if individual
Mailing address
City
Branch number
State
ZIP code
Section 6 - Owner(s) Signature
I declare that I am the owner of the vehicle described on this application and that all the above information is accurate and true. I certify that I will maintain in effect owner’s or
operator’s security (insurance) for this vehicle as required by law in order to operate this vehicle on a highway, quasi-public road, or parking area within this state.
Date
Owner’s signature
X
Co-owner’s signature
X
Date
Section 7 - Purchase and Dealer Information (This Section for Utah Dealership Use Only)
I certify that the vehicle is accurately described on this application and has been delivered to the purchaser named above and that this dealership is in compliance with the
licensing requirements set forth in Title 41 Chapter 3 Part 2 of Utah Code. I also certify that this transaction was completed in compliance with the sales tax reporting
requirements set forth in Section 59-12-107 of Utah Code.
Purchase date
Dealer number
Used
New
Permit issue date
Permit number
Dealer/Authorized representative’s signature
X
Date