STATE OF INDIANA
DELAWARE COUNTY 		) SS:
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IN THE DELAWARE CIRCUIT COURT
COURT NO.
IN THE MATTER OF:
VEHICLE TITLE REQUEST
FOR:
(Insert Year, Make, and Model)
(Insert VIN#)
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)
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CAUSE NO. 18C0

VERIFIED REQUEST FOR COURT
ORDER TO ISSUE VEHICLE TITLE

Comes now the Petitioner, under oath, and requests the Court to order the Indiana Bureau of Motor Vehicles to issue a title to the Petitioner for the following vehicle. To support this Request, the Petitioner states to the Court as follows:

1. Petitioner’s Full Name:
Petitioner’s Address:
County of Residence:
Telephone Number:
2. Description of Vehicle:
Type of Vehicle:
Manufacturer:
Make/Model:
Year:
Estimated Value:
VIN Number: