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Iowa Motor Vehicle Power of Attorney (Form 411021)

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Iowa Motor Vehicle Power of Attorney (Form 411021)

Updated June 02, 2022

An Iowa motor vehicle power of attorney (Form 411021), or Iowa Department of Transportation Power of Attorney Authorization, is the form used when an individual wants someone else to stand in their place to handle their motor vehicle issues, including titling. This paperwork must be submitted to and approved by the Iowa Department Of Transportation so that it can be utilized by the agent to perform any actions on the individual’s behalf.

How to Write

1 – Open The Form On This Page To Fill Out And Submit To The Iowa Department Of Transportation

The form required to designate a power of attorney over one of a Principal’s vehicles is accessible through the button beneath the image. Click on the appropriate file type, then open this form to work on. If you have a compatible program, you may enter the information then print it. If not, open the form with an updated browser, print it, then fill it out.

2 – Indicate The Reason For Generating This Paperwork

There are several reasons to submit this paperwork to the Iowa Department Of Transportation. In fact, each reason will be listed at the top of this form with a corresponding checkbox. Check the box corresponding to the reason you are filing this form: Application for Certificate Title, Assignment of Certificate Title, Application for Replacement Certificate of Title, Application for Notation of Security Interest, Motor Vehicle Odometer (Mileage) Statement, Damage Disclosure Statement, and/or Application for Refund for a Leased Vehicle. Typically, this paperwork will be attached to one or more of these items. Unless otherwise indicated by the IA DOT, attach this form (when completed) to the document it applies to when it is time to submit the paperwork.

3 – The Principal Declaration Of Assignment And Approval Of Principal Power Over The Vehicle

The Identity and Location of the Principal and Agent must be included in the necessary language of the paragraph beneath the words “Know All Persons By These Presents.” Such information will be unique in every situation; thus, you will need to physically enter this information where it is appropriate.

The Principal’s First Name, Middle Name, and Last Name should be Printed on the blank line following the words “That the undersigned…”The Principal’s Address (as it appears on the books with the IA DOT) should be typed in or printed onto the blank line labeled “Address in Full”Next, enter the County and State where the Principal maintains his or her Residence on the two blank lines following the words “…a Resident of.”The next bit of required information will serve to appoint power to an individual. Enter the Full Name and Complete Address of the individual who will assume Principal Power over the Vehicle in question. This should be clearly presented on the blank lines following the words “…constitute and appoint.”The final required piece of information in this statement will be near the end of the paragraph and include a table to fill out. This will serve as a manner to identify the Principal Vehicle the Agent may wield Principal Power over. Enter the Complete Title Number (if known) on the last blank space of this statement.The table presented beneath the Title Number must have all the requested information supplied. On the first row, report the Vehicle’s Make, Style, and Year in the appropriately labeled boxes.

In the second row, record the Vehicle’s Identification Number, Model, and the Color of the Vehicle in the three boxes provided (“V.I.N.,” “Model,” “Color of Vehicle”).

4 – The Principal Should Execute This Form With A Notarized Signature

The Principal Car Owner should read the disclosure below the table then report the Physical Address where he or she is signing this form on the blank line labeled “Signed at.”

The Principal Car Owner must also indicate what the Date of his or her signature is using the three spaces provided. This date should be written out in words as the Calendar Day (first, second, third, etc.), Month, and Year he or she signed this document.

On the blank space, preceding the word “Owner,” the Principal Vehicle Owner must sign his or her name. Below this will be a set of blank spaces following the phrase “State of Iowa.” The Notary Public will fill in the information required then notarize this document.