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Illinois Power of Attorney to Obtain Title Documents Form


Illinois Power of Attorney to Obtain Title Documents Form
Illinois Power of Attorney to Obtain Title Documents Form
POWER OF ATTORNEY
TO OBTAIN TITLE DOCUMENTS AND ILLINOIS
TITLE IN ACCORDANCE WITH ILLINOIS COMPLIED STATUES
CHAPTER 770 50/1-50/6 (lien $2,000 or less)
CHAPTER 770 45/1 et seq. or CHAPTER 770 90/1 et seq. (lien more than $2,001)
625 ILCS 5/3-117.1
(MECHANIC’S LIEN LAW)
I,
Please Print Name
APPOINT TITLE SERVICES OF ILLINOIS AS MY ATTORNEY IN FACT TO SIGN ALL PAPERS AND DOCUMENTS
REQUIRED TO SECURE AN ILLINOIS TITLE FOR THE VEHICLE DESCRIBED BELOW, EXACTLY AS STATED
Please Sign Name
ILLINOIS DRIVERS LICENSE #
DATE OF BIRTH ______/______/______ SEX M ٱ F ٱ OWNERٱ MANAGERٱ EMPLOYEE ٱ
EMAIL
@ x
NAME OF BUSINESS
ADDRESS OF BUSINESS
CITY STATE ZIP CODE
PHONE ( ) __________________________ COUNTY _______________
FAX ( ) __________________________ LIEN AMOUNT $ __________________
(Total of Your Invoice)
DATE VEHICLE SERVICE WAS PROVIDED ______/______/______
(This should be the date the vehicle was towed or the date the repairs were started)
WHAT IS YOUR NEW OR USED CAR DEALER # ___________________ PHOTOCOPY OF CURRENT
DEALER LICENSE,
WHAT IS YOUR ILLINOIS REBUILDER U.D.L. # ___________________ REBUILDER OR REPAIRER
UDL MUST BE INCLUDED
WHAT IS YOUR ILLINOIS REPAIR U.D.L. # ___________________ TO BE TAX EXEMPT.
VEHICLE INFORMATION
YEAR _________ MAKE ____________________ MODEL ___________________ BODY ____________
VEHICLE IDEN. NO. (VIN) ___/___/___/___/___/___/___/___/___/___/___/___/___/___/___/___/___
17 Digits
ILLINOIS LICENSE PLATE # ___/___/___/___/___/___/___ EXPIRES MONTH____YEAR_____
OTHER STATE PLATE
VEHICLE COLOR ____________ TODAY’S DATE _________/__________/_________
Month Day Year
I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THE ODOMETER READING
IS THE ACTUAL MILEAGE OF THE VEHICLE ___________________
Actualٱ Not Actualٱ
Illinois Power of Attorney to Obtain Title Documents Form