Duplicate
Certificate of Title
Application and Affidavit
To:
Debra K. Lathrop
Laramie County Clerk
P.O. Box 608
Cheyenne, WY 82003
FOR
OFFICE USE ONLY
Date
received: _______________
Issue date: _________________
Date Mailed: ________________
CSR Initials: ________________
I/We
hereby make application for a duplicate Wyoming Certificate
of Title for the following motor vehicle, trailer, or
mobile home, as described below:
Title
Number: ______________________
Make: ____________________________
To
the best of my knowledge and belief there are no liens,
other than those liens shown on the original certificate
of title. The title has been (check one)
lost,mutilated, or
destroyed and has not been assigned to any other
person, nor is it in the possession of any other person.
I/We
authorize the duplicate certificate of title be mailed
to:
I/We
hereby swear or affirm under penalty of perjury that all
the information on this application for Certificate of
Title is true and correct and that I am lawfully applying
for a Wyoming Certificate of Title.
Signature
of applicant: ____________________________________________
Signature of applicant: ____________________________________________
Subscribed and sworn to before me in the county of ____________________
and state of ____________ this ________ day of ___________
20 ________
