Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696583134431.pdf (United States)
FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES APPLICATION FOR CERTIFICATE OF MOTOR VEHICLE TITLE Please submit this form to your local tax collector office or license plate agency.

https://www.flhsmv.gov/locations Note: All fields are required unless otherwise stated or not applicable.
Application Type: ☐ Original ☐ Transfer Request to print Certificate of Title: ☐ No ☐ Yes: In office ☐ Yes: Mailed Off-Highway Vehicle Type: ☐ All-Terrain Vehicle (ATV) ☐ Recreational Off-Highway Vehicle (ROV) ☐ Off-Highway Motorcycle (OHM) Section 1: OWNER/APPLICANT INFORMATION Customer Number Fleet Number I Unit Number I Owner's County of Residence I I Are you a Florida Resident?

☐YES ☐ NO Are you a US Citizen?

☐YES ☐NO Are you deaf or hard of hearing?


(Voluntary) ☐YES ☐NO I Owner Details: When joint ownership, please indicate if “or” or “and” is to be shown on title when issued.

☐ OR ☐ AND (If neither box is checked, the title will be issued with "and.")
Owner’s Name as It Appears on Driver License (First, Full Middle/Maiden, & Last Name) I Select, if applicable: I ☐ Tenancy by the Entirety Owner’s Phone Number (Voluntary) Owner’s Email (Voluntary) ☐ Life Estate/Remainder Person ☐ With Rights of Survivorship Date of Birth Sex FL DL/ID or FEID/Suffix Number Owner’s Mailing Address I Owner’s Residential Street Address City City State Zip Code State Zip Code Mail To Customer Name (If different from above owner) Mail To’s Phone Number (Voluntary) Mail To’s Email (Voluntary) Sex Date of Birth FL DL/ID or FEID/Suffix Number Mail To’s Address (If different from above mailing address) City State Zip Code I I Co-Owner Details: Are you a Florida Resident?
☐YES ☐NO Are you a US Citizen?

☐YES ☐NO Are you deaf or hard of hearing?
(Voluntary) ☐YES ☐NO ☐ Co-Owner or ☐ Lessee’s Name as It Appears on Driver License Date of Birth (First, Full Middle/Maiden, & Last Name) Co-Owner’s Phone Number (Voluntary) Co-Owner’s Email (Voluntary) Sex I I FL DL/ID or FEID/Suffix Number Co-Owner’s/Lessee’s Mailing Address I Co-Owner’s/Lessee’s Residential Street Address City City State Zip Code State Zip Code Section 2: MOTOR VEHICLE DESCRIPTION Vehicle Identification Number (VIN) Florida Title Number Make/Manufacturer Model Year Body I Color I License Plate Number I Length Ft.___ In___ 1- Weight I Previous State of Issue I GVW I BHP/CC I Van Use (If applicable) ☐Passenger ☐Other Fuel Type ☐ Natural Gas (Liquid) ☐ Natural Gas (Compressed) ☐ Hybrid (Gas/Electric) ☐ Hybrid (Diesel/Electric) ☐ Electric Section 3: BRANDS, USAGE AND TYPE (Check applicable types) ☐Assembled from Parts ☐Autonomous ☐Long Term Lease ☐Kit Car ☐Manuf.
Buy Back ☐Police Veh.

☐Private Use ☐Rebuilt ☐Replica ☐Short Term Lease ☐Street Rod ☐Taxicab ☐Electric ☐Flood ☐Glider Kit ☐Bonded Title ☐Custom ☐ILEV Section 4: LIENHOLDER INFORMATION (If applicable) ELT Customer ☐YES ☐NO ☐ FEID/Suffix # ☐DMV Account # ☐DL/ID #, Sex and DOB Lienholder’s Phone Number (Voluntary) Lienholder’s Email (Voluntary) Date of Lien Lienholder’s Mailing Address City I State I Zip Code I Lienholder’s Name (If box is not checked, title will be mailed to the first lienholder.)
☐ Check this box if you, lienholder representative, authorize the Department to send I the motor vehicle title to the owner and sign here: ____________________ Section 5: TRANSFER TYPE (If applicable) If ownership has transferred, how and when was the motor vehicle acquired?

☐Sale (Price: $__________ .


____ ) ☐Gift ☐ Repossession ☐Court Order ☐Inheritance ☐Other (Specify): ____________________ Date Acquired: I _____ / _____ / _______ Section 6: ODOMETER DECLARATION WARNING: Federal and State law requires that you state the mileage in connection with an application for a Certificate of Title.

Failure to complete or providing a false statement may result in fines or imprisonment.

I/we state that this ☐5 or ☐6-digit odometer now reads ___ ___ ___ , ___ ___ ___ .xx miles.
I/we hereby certify that to the best of my/our knowledge the odometer reading: ☐ 1.

REFLECTS ACTUAL MILEAGE.

☐ 2.

IS NOT THE ACTUAL MILEAGE.

(No tenths) Date Read: _____ / _____ / _______.

☐ 3.

IS IN EXCESS OF ITS MECHANICAL LIMITS.

HSMV 82040 MV – Rev.
07/23 https://www.flhsmv.gov RULE 15C-21.001, FAC FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES APPLICATION FOR CERTIFICATE OF MOTOR VEHICLE TITLE Section 7: DEALER SALES TAX REPORT AND MOTOR VEHICLE TRADE IN INFORMATION (If applicable) Florida Sales Tax Registration Number Dealer License Number Date of Sale Amount of Tax Dealer/Agent Signature Year of Trade In Make of Trade In Title Number of Trade In (If known) Vehicle Identification Number (VIN) of Trade In Section 8: MOTOR VEHICLE IDENTIFICATION NUMBER VERIFICATION This section requires a physical inspection and a verification of the vehicle identification number (VIN) (or the motor number for motor vehicles manufactured prior to 1955) of the motor vehicle described on this form by a licensed Florida dealer, Florida notary public, law enforcement officer, or authorized FLHSMV, tax collector (TC) or license plate agency (LPA) employee.
Complete this section on all used motor vehicles, including trailer (with abbreviation of “TL” and a weight of 2,000lbs or more), not currently titled in Florida.
I, the undersigned, certify that I have physically inspected the above-described vehicle: Vehicle Identification Number (VIN) Name Certifying Inspector I Certifying Inspector Signature I Date I ☐ Florida Notary Public (Stamp or Seal) Select which option best represents the certifying inspector: ☐ Law Enforcement ☐ Florida Dealer ☐ FLHSMV ☐ Tax Collector or Agency Name: ___________________________ Badge Number: _________________ Dealer Name: ___________________________ Dealer Number: _________________ Office Name: ___________________________ User ID/Badge: _________________ Agency Name: ___________________________ County/Agency: _________________ License Plate Agency Signature: ________________ Section 9: SALES TAX EXEMPTION CERTIFICATION (If applicable) The purchase of a recreational vehicle to be offered for rent as living accommodations does not qualify for exemption.
I certify the motor vehicle described has been purchased and is exempt from the sales tax imposed by Chapter 212, Florida Statutes, by: ☐ Purchaser (state agencies, counties, etc.)

holds valid exemption certificate Consumer’s Certificate of Exemption Number: __________________ I hereby certify that ownership of the motor vehicle described on this application, is not subject to Florida Sales and Use Tax for the following reason: ☐ Vehicle will be used exclusively for rental.
I Sales Tax Registration Number: _________________________ Inheritance ☐ Gift ☐ Divorce Decree ☐ Transfer between a married couple ☐ Other: _________________________ ☐ ☐ Even trade or trade down _____________________________________________________________________ (State the facts of the even trade or trade down and the transferor information, including the transferor’s name and address.)
Section 10: REPOSSESSION DECLARATION I certify that this motor vehicle was repossessed upon default in the terms of the lien instrument and is now in my possession.

☐ Section 11: NON-USE AND OTHER CERTIFICATIONS If checked, the following certifications are made by the applicant: ☐ I certify that the certificate of title is lost or destroyed.

☐ The vehicle identified will not be operated on the streets and highways of this state until properly registered.
☐Other: (explain) _____________________________________________________________________________ Section 12: APPLICATION ATTESTMENT AND SIGNATURES I/We physically inspected the VIN.

(More than one form HSMV 82040 may be used for additional signatures.)

Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
Full Name of Applicant, Owner Signature of Applicant, Owner Full Name of Applicant, Co-Owner Signature of Applicant, Co-Owner Date Date Section 13: RELEASE OF SPOUSE OR HEIRS INTEREST (If applicable) The undersigned person(s) state(s) that ____________________________________________________________________ died on _______________.

(Name of deceased) (Date) Testate (with a will) Intestate (without a will) and left the surviving heir(s) named below.
When applicable, the heir(s) (named below) certifies that the certificate of title is lost or destroyed.

☐ ☐ Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.

(More than one form HSMV 82040 may be used for additional signatures.)
Full Name of ☐ Spouse, ☐ Co-Owner or ☐ Heir(s) Signature of Spouse, Co-Owner or Heir(s) ☐ Full Name of ☐ Spouse, ☐ Co-Owner or ☐ Heir(s) Signature of Spouse, Co-Owner or Heir(s) Date Date That at the time of death the decedent was owner of the motor vehicle described in section 2 of this form.
The person(s) signing above hereby releases all of his/her/their right, title, interest and claim as heir(s) at law, legatee(s), devisee(s), or otherwise to the aforesaid motor vehicle to: Full Name of Applicant Signature of Applicant Date Full Name of Applicant Signature of Applicant Date HSMV 82040 MV – Rev.

07/23 https://www.flhsmv.gov RULE 15C-21.001, FAC