Who is the vehicle owner? This individual gives the power to sell, register, title, or any other rights to their vehicle. Do you know the vehicle owner's mailing address? YesNo, I will write it in later. Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Who is the agent? This individual or entity ("Attorney-in-Fact") receives the power to act on the Vehicle Owner's behalf. Do you know the agent's mailing address? YesNo, I will write it in later. Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code The agent is authorized to handle the following: (check all that apply) Title and Registration – Transfer title, register vehicle, renew registration, etc.Purchase and Sale – Buy, sell, negotiate terms for vehicle, etc.Insurance – File claims, pay premiums, etc.Maintenance and Repair – Handle costs and decisions for vehicle upkeepOther Specify: Do you want to enter vehicle information (i.e. year, make, model, etc.)? YesNo, I will write it in later. Make Model Body Style Color Year Vehicle Identification Number (VIN) 17 characters Do you want to add a section for notary acknowledgment? (Optional) YesNo Notarizing this form is not legally required in the State of California. Next Save Save and finish later
