Updated June 02, 2022
A Mississippi Motor Vehicle Power of Attorney, or ‘Form 78-003-10-1-1-000’, is a document used to appoint someone to to sell or transfer another person’s motor vehicle in Mississippi. This is a type of limited, or specialized POA that is only for a specifically defined purpose – namely to sell or transfer your vehicle to another person or entity.
How to Write
1 – Open The Appointment Form On This Page
Make sure you have the Grantor, Agent, and Vehicle Information where you may easily reference it. All the requested items on this form must be reported accurately. This form may be opened using a PDF, Word, or ODT editing program. In the absence of such software, you may open the PDF file with a current browser then, printing the document. You may open and download the appropriate file using the buttons labeled “PDF,” “ODT,” or “Word.”
2 – Document Grantor Information
Before we begin, enter the County whose laws apply to the Vehicle on the first blank line on this page (just after the words “County of”). 
The Grantor of Power is the Vehicle Owner who is appointing an Agent with the same Principal Authority he or she has over the Vehicle being discussed. This individual’s information will be the first to be requested. Enter the Grantor of Power’s Name on the blank line following the words “That I.”
Further this identification of the Grantor by entering his or her Address on the blank line labeled “Address.” Make sure this is the Physical Address of the Grantor’s Residence. 
The blank space between the terms “…Of The County Of” and “…the State of Mississippi” must have the Name of the County where the Grantor lives documented.
3 – Record Agent Information
The Agent is the individual who will be permitted to assume and wield Principal Authority over the Vehicle as a result of this form’s execution. You must enter this Agent’s Full Name on the first blank space following the term “…Constitute And Appoint”
Enter the Agent’s Complete Residential Address on the second blank space after the phrase “…constitute and appoint.”
On the last blank line of this paragraph, enter the Mississippi County where the Agent resides. 
4 – Report Vehicle Information
Once the task of identifying both the Granting Vehicle Owner and the Agent, we must make sure to clearly define the Vehicle at the focus of this document. To begin, locate the blank line after the words “…Assign The Motor Vehicle Described As Follows To Wit: Make,” then enter the Make of the Vehicle on it. 
On the blank space labeled “V.I.N.,” enter the Vehicle Identification Number of the Vehicle. 
Next, enter the Year and Body Type of the Vehicle on the blank lines labeled “Year” and “Body Type” respectively. 
Finally, report the Title Number of the Vehicle on the last empty line. 
5 – Verify The Odometer Reading
Locate the box the labeled “Odometer Reading” then enter the Mileage displayed on the Vehicle’s Odometer. 
If the mileage of the Vehicle exceeds the Odometer’s limits to measure, mark the blank line first blank line. If not, then leave this blank. 
If the mileage on the Vehicle’s Odometer differs from the actual mileage (for any reason), then mark the blank line labeled “2.” 
6 – Notarize Grantor Signature
There will be several items required to execute this document correctly. First, the Signature Grantor must enter the Date using the three blank spaces after the words “…hereunto set my hands this,” by recording the Calendar Date, Month, and Year he or she is signing this form. 
The Grantor must sign his or her Name on the blank line labeled “Signature Of Owner, Grantor.” 
On the blank line below his or her signature, the Grantor must Print his or her Name. If the Vehicle is owned by a Business Entity, make sure to the Name of the Business Entity and the Title of the Grantor is presented as well.
The final area of this document is reserved for the attending Notary Public. This individual will notarize the Principal signing of this document.