| A. Applicant and vehicle information | Name, phone, email, street address, city, state and ZIP; then vehicle identification number, make, year model, model, body type and a mobile home length and width. |
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| B. Purchase information | A printed certification that the vehicle is free and clear of all liens except those identified, that the applicant will guarantee title to any future owner, and that the value is $3,000 or less or the vehicle is at least thirty years old - followed by the date of purchase, who it was bought from, that person's full address and telephone, the price, and a lienholder block. |
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| C. Statement of facts | Three lines under the heading: applicant cannot furnish proper documents for the following reason(s). |
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| D. Vehicle value statement | Only for a vehicle under thirty years old bought for more than $3,000 whose value has since fallen to $3,000 or less, with three lines to say why. |
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| E. Acknowledgement | The perjury sentence, the signature of the certifier and the date. |
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| Page two, the supporting documents | Five numbered requirements that apply only to a vehicle under thirty years old: notification, VIN verification, a notarised bill of sale or statement, photographs for a rebuilt vehicle, and a certified copy of a lost manufacturer's statement of origin. |
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| The notification rule | Certified letters with return receipt requested to all known parties with a legal interest, with the green cards submitted; or, where the previous owner is unknown, a newspaper notice in the county of application giving make, model, year and vehicle identification number and asking any interested party to make contact within ten business days. |
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| The chart | $0.00 to $3,000.00, certification of ownership. $3,001.00 and above, corporate surety bond or personal bond with two solvent personal sureties. Thirty years or older regardless of value, certification of ownership. |
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