How to fill out Missouri Form 4054

The ordinary power of attorney for a vehicle: one page appointing somebody to sign for you, for one of three named purposes, on one described unit. It is the answer to an owner who is deployed, in hospital or three states away when the car sells - and, unlike the title assignment it stands in for, it has to be notarised.

Top of the blank Missouri Form 4054, Power of Attorney, as the agency publishes it

Step 1 · the form itself Blank Form 4054 — Power of Attorney PDF at dor.mo.gov · new tab View the blank Form 4054

Top of our filled-in example of Missouri Form 4054, Power of Attorney

Step 2 · how to fill it in Our filled-in Form 4054 guide PDF · 2 pages · 460 KB · new tab See our filled-in example

Two documents, and they are not the same thing. Take the blank Form 4054 from the dor.mo.gov copy so you get the revision that is current today, then print our Form 4054 guide and keep it beside you while you fill theirs in.

Written against Form 4054 (Rev 05-2025), issued under RSMo 301.190 and 407.536. Read the purpose boxes as the limits they are. Transferring ownership, applying for title and applying for registration are three different acts, and an attorney-in-fact appointed to do one of them cannot do the other two. Where the person signing will need to do all three, all three get ticked.

Last updated August 22, 2026.

Filled in

What a completed one looks like

This is the actual Form 4054, rendered from the PDF the Missouri Department of Revenue publishes and completed end to end: letterhead, every field, and the blocks at the foot.

Amber — you write it
Grey — not yours to fill
Numbered — explained below

Missouri Form 4054 filled in: Delphine R. Tallmadge appoints Thaddeus L. Krumholz as attorney-in-fact, the transferring ownership box ticked, a 2016 Subaru with identification number 4S4BSANC1G3271486, the owner's printed name and signature dated 08/03/2026, the two spare owner rows left blank, the insurance company block empty, and the notary block completed by Renata F. Quisenberry of Jackson County with a commission expiry of 03/28/2029. — One appointee, one purpose, one vehicle, one owner. The insurance company block near the top is grey because it belongs to a total-loss appointment, and the two unused owner rows are grey because this car has a single name on its title.

Field by field

Every line, in the order you meet it

1
You fill this in
Who you are appointing
The attorney-in-fact's full name, written into the rule at the top of the page.
Watch out: Write it before you sign, not after. A form signed with that line empty is a blank authority to transfer your car to anybody.
2
You fill this in
The insurance block, usually empty
Insurance company name and date of total loss, sitting immediately under the appointment line.
Watch out: It is only for appointing an insurer after a write-off. On any other appointment it stays blank, and the bracketed instruction above it says so.
3
You fill this in
The purpose
Transferring ownership, making application for title, or making application for registration.
Watch out: These are separate powers. Ticking transferring ownership does not let your attorney-in-fact apply for a duplicate title on your behalf.
4
You fill this in
The unit
Year, make and identification number - the form's word, because it covers boats and outboard motors as well as cars.
Watch out: One unit per form. A second vehicle needs a second appointment, even to the same person on the same day.
5
You fill this in
Printed name, signature and date
The first of three owner rows.
Watch out: Every owner named on the face of the title fills in a row. Where there are more than three, the Department takes a second form rather than a squeezed line.
6
You fill this in
The notary
The band under the three owner rows, which is where this form stops being a piece of paper and becomes an authority.
Watch out: The whole document turns on it. This is one of the three places Missouri requires a notary in a private sale, and the only one that is about you rather than a lender.

At a glance

What goes where

On the form	What to put in it
I (we) hereby appoint	A ruled line for the attorney-in-fact's name, with a bracketed instruction directly beneath it for the case where the appointee is an insurance company on a total loss.
Insurance company block	Insurance company name and the date of total loss, in eight cells - completed only in that one case.
Purpose	Three tick boxes: transferring ownership for the following described unit; making application for title for the following described unit; making application for registration for the following described unit.
The unit	Year in four cells, make, and the identification number.
The grant	Printed after the vehicle line: with the full authority to sign on my (our) behalf all papers and documents and to do all that is necessary to this appointment.
Signature block	Three pairs of rules - owner's printed name and owner's signature with a date - so that every owner on the title can appoint the same person.
Notary Information	The block that makes the appointment effective - stamp space, the date spelled out, the jurisdiction, and the witnessing officer's signature, printed name and expiry date.
The asterisk	A footnote against the signature rules: owner(s) electronic signature is permissible ONLY when assigning power of attorney to an insurance company due to total loss. Notarization is required for all signatures.

What gets this one rejected

•An unnotarised signature. The footnote is unambiguous - notarization is required for all signatures - and the only exception is an electronic signature to an insurance company on a total loss.
•No purpose ticked. The three boxes are the scope of the appointment, and a power of attorney with no stated purpose grants nothing.
•A blank name on the appointment line. Signing that and handing it over is a signed blank authority over your vehicle.
•Using it alongside a secure power of attorney. The Department's titling manual states the rule in nine words: a regular POA cannot be used in conjunction with a secure POA.
•Using it to sign the odometer disclosure where the title is simply unavailable. That situation is what the secure Form 5086 exists for, and the federal rules behind it are why it is printed on secure stock.
•One owner signing for two. There are three printed signature pairs on the form for a reason.

Rules that decide whether it is accepted

•Three signature pairs, one appointee. Every owner shown on the face of the title signs their own line, and they are all appointing the same person.
•A license office will notarise it for $2.00. Printed above the notary block. That is the same counter the buyer's title application goes over.
•The insurance exception is narrow. An electronically signed power of attorney to an insurer needs no notarisation, is only available where odometer disclosure is not required, and the manual adds that it is not acceptable for marine transactions.

Every line here was read off Form 4054 (Rev 05-2025) itself — the PDF is here — and off the Missouri Department of Revenue pages. This is plain-language help with a form, not legal advice, and where our wording and the agency's differ, theirs governs.

Forms that go with this one

Form 5086 · Secure Power of Attorney

Away when your car is towed in Kansas City? Our city page explains the notarized letter someone else needs at the Kansas City Tow Lot.

Back to all Missouri seller paperwork, or what selling a car in Missouri involves.

How to fill out Missouri Form 4054

What a completed one looks like

Every line, in the order you meet it

Who you are appointing

The insurance block, usually empty

The purpose

The unit

Printed name, signature and date

The notary

What goes where

What gets this one rejected

Rules that decide whether it is accepted

Forms that go with this one

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