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Mississippi Motor Vehicle Power of Attorney Form

The Mississippi motor vehicle power of attorney is a legal document used by the grantor to authorize the attorney-in-fact to act on his/her behalf in matters related with the motor vehicle.

Mississippi Motor Vehicle Power of Attorney Form
Mississippi Motor Vehicle Power of Attorney Form
POWER OF ATTORNEY TO TRANSFER MOTOR VEHICLE
This document shall pass with the certificate of title and be included as a support document
to application for new certificate of title and/or application for replacement certificate of title.
THE STATE OF MISSISSIPPI
COUNTY OF _______________________ KNOW ALL MEN BY THESE PRESENT:
THAT I, __________________________________________________________________________________________________
________________________________________________________________________________________, OF THE COUNTY OF
________________________________________________________________________and the STATE OF MISSISSIPPI, owner of
the following described motor vehicle, have made, constituted and appointed and by these present do make, constitute and appoint
___________________________________________________________________________________________________________
________________________________________________________________________________________, OF THE COUNTY OF
________________________________________________________________________ and the STATE OF MISSISSIPPI, my true
and lawful attorney, for me and in my name, place and stead to sell, transfer and assign the motor vehicle described as follows to wit:
MAKE____________________________ V.I.N.___________________________________________
YEAR____________________________ BODY TYPE_____________________________________
TITLE NUMBER______________________________
giving and granting unto my said attorney full power and authority to do and perform all and every act requisite and necessary to
transfer and assign the legal title to said motor vehicle to anyone whomever, as may be designated by said attorney.
FEDERAL and STATE LAW requires that you state the mileage in connection with the transfer of ownership. Failure to complete
or providing a false statement may result in fines and / or imprisonment.
I certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following
statements is checked.
_____ 1. I hereby certify that the mileage state is in excess of the mechanical limits of
Odometer Reading the odometer.
(No Tenths) _____ 2. The odometer reading is not actual mileage. WARNING-ODOMETER DISCREPANCY
IN WITNESS WHEREOF I HAVE hereunto set my hand this __________________________day of _______________,
20_______ .
______________________________________________________________________
______________________________________________________________________
Before me, the undersigned authority, on this day personally appeared_________________________________________________
known to me to be the person whose name is subscribed to the above foregoing instrument, and acknowledge to me that he executed
the same for the purposes and consideration therein expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE THIS________________________day of ________________A.D.,
20________.
________________________________________________________
GRANTOR, NAME TO APPEAR IN SAME FORM AS CONTAINED IN CERTIFICATE OF TITLE
(ADDRESS)
(ADDRESS)
Signature of Owner, Grantor
Printed Name of Grantor (if Title is in Company Name, include appropriate Title, Partner, President, Sec. Treas., etc.)
(Individual Name Only)
Notary Public
Form 78-003-10-1-1-000
Title Bureau, P. O. Box 1383, Jackson, MS 39215 www.dor.ms.gov Phone 601-923-7200 Fax 601-923-7224
Mississippi Motor Vehicle Power of Attorney Form