Tennessee > Secretary Of State > Miscellaneous
Application For Motor Vehicle Temporary Lien SS-4258 - Tennessee
| Application For Motor Vehicle Temporary Lien Form. This is a Tennessee form and can be used in Miscellaneous Secretary Of State . |
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For Office Use Only Motor Vehicle Temporary Lien Program 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, TN 37243 APPLICATION FOR MOTOR VEHICLE TEMPORARY LIEN Return Acknowledgement Notice To: Name Address Control Number: City , State Zip Code Business or Name First (Filing Office Use Only) Lienholder Information: Motor Vehicle Identification Number: Middle Last Address Instrument Creating Lien Executed On: / MM DD / Year City , State Zip Code Debtors / Lessee Information: Business or Name First Middle Last Payment Method Check Voucher Number Number Address , City State Zip Code In order to record a motor vehicle temporary lien, this form MUST be completed (typed or printed in ink) in its entirety and returned with a notarized copy of the instrument creating the lien and the required fee of $10.00 (ten dollars) to: Tennessee Department of State Motor Vehicle Temporary Lien Program 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, Tennessee 37243-0306 (615)741-0529 SS-4258 RDA 836-1 American LegalNet, Inc. www.USCourtForms.com
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