VR450 VR 450
User Manual: VR450
Open the PDF directly: View PDF 
.
Page Count: 1
VR-450 (08-17)
Purpose: Use this form to certify ownership and apply for title and required decal of an off road motorcycle, ATV, snowmobile,
moped, motor scooter or UTV when the certicate of title or manufacturer’s certicate of origin is unavailable.
Instructions: Complete this form in its entirety. All forms and applicable fees shall be submitted electronically to the Motor Vehicle
Administration via an ERT participant or online at www.mva.maryland.gov. For a listing of ERT participants, please
visit our website at www.mva.maryland.gov. The decal will be mailed to you and should be displayed on the rear of
the vehicle in a visible position.
Afdavit of Ownership – Moped, Motor Scooter & Off Road Vehicle
OWNER INFORMATION
OWNER NAME (PRINT) CO-OWNER NAME (PRINT)
OWNER’S SOUNDEX DATE OF BIRTH CO-OWNER’S SOUNDEX DATE OF BIRTH
STREET ADDRESS CITY STATE ZIP CODE
VEHICLE INFORMATION
TYPE OF VEHICLE: q Off Road Motorcycle q AT V q Snowmobile q Moped q Motor Scooter q UTV
YEAR MAKE MODEL BODY STYLE COLOR VEHICLE IDENTIFICATION NUMBER (VIN)
DATE OF PURCHASE ________________________________ PURCHASE PRICE ________________________________
CERTIFICATION
I/We certify under penalty of law that the operator(s) of the mopeds and motor scooters will carry evidence of required insurance and wear
protective headgear. Operators must also wear protective eye gear unless moped or motor scooter is equipped with a windscreen.
Knowingly making a false statement on this form is punishable by a ne of $1,000 and 10 years imprisonment.
I solemnly afrm under penalties of perjury and upon personal knowledge the contents of the foregoing document are true and correct to the best of
my knowledge and belief.
I/We further certify that should any legal action arise as a result of issuing a Certicate of Title my/our application for same, herein described, I/we
hereby bind ourselves, our heirs, assigns and personal representatives to indemnify and save harmless the Maryland Motor Vehicle Administration for
any loss or damage which may be asserted against or which may be sustained as a result thereof.
Any willful misinformation provided with fraudulent intent may be prosecuted under Maryland law.
OWNER’S SIGNATURE OWNER’S PRINTED NAME DATE
CO-OWNER’S SIGNATURE CO-OWNER’S PRINTED NAME DATE
Decal Number (MVA Use Only) _____________________
LIEN INFORMATION
If this vehicle is subject to any liens or encumbrances, complete the following section(s). LIEN FILING FEE $20 for each lien led. IF NOT SUBJECT TO A LIEN, WRITE
THE WORD “NONE” BELOW.
NAME OF SECURED PARTY STREET ADDRESS OF SECURED PARTY
CITY STATE ZIP CODE
KIND OF LIEN (DESCRIBE) DATE OF LIEN AMOUNT OF LIEN ACCOUNT NUMBER
6601 Ritchie Highway, N.E., Glen Burnie, Maryland 21062
For more information visit our website at www.mva.maryland.gov, call 410-768-7000 or TTY for the hearing impaired: 1-800-492-4575.
