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a >.9. MANUFACTURED (MOBILE) HOME PERMIT
\� , `f`. "t State Form 7878(R9/3-20)
\ ,/ Prescribed by the Department of Local Government Finance
.•-roii.---,-."7 COPY
I Type of mobile home permit:
I ❑Section A-For Moving Section B -Transferring Title (NOTE: Separate permits required if owner intends to both move and transfer title.)
INSTRUCTIONS:
1. A mobile home may not be moved from one location to another unless the owner obtains a permit to move the mobile home from the county treasurer.
2. The Bureau of Motor Vehicles may not transfer the title to a mobile home or change names in any manner on the title to a mobile home unless the owner obtains a
permit to transfer the title from the county treasurer.(IC 6-1.1-7-10)
3. A county treasurer shall issue a permit which is required to either move,or transfer the title to a mobile home if the taxes,special assessments.interest.penalties,
judgments,and costs that are due and payable on the mobile home have been paid. The permit shall state the date it is issued. The treasurer must issue the
permit not later than two(2)business days(excluding weekends and holidays)after the date the treasurer receives a completed permit application.(iC 6-1.1-7-10)
4. A mobile home owner who sells the mobile home to another shall provide the purchaser with the permit required before the sale is consummated. This obligation
does not apply to a mobile home offered for sale at an auction under/C 9-22-1.5 or/C 9-22-1.7.(IC 6-1.1-7-10.4) A person who violates this commits a Class C
infraction.(IC 6-1.1-7-14)
5. A mobile home owner must present a copy of this permit to the Bureau of Motor Vehicles when applying for title transfer. If the mobile home is to be moved,a
separate permit must be requested prior to moving.
6. A Form 1(Notice of Placing of Mobile Home Upon Land or Lot)must be filed with the assessor within thirty(30)days after the date of placement of the mobile
home(IC 6-1.1-7-3)
7. The requirement to obtain a permit to move or transfer title to a mobile home does not apply to a mobile home that is offered for sale at auction under
iC 9-22-1.5.IC 9-22-1.7,or iC 6-1.1-23.5 for the transfer resulting from the auction. (iC 6-1.1-7-10(a))
8. Documentation provided by person requesting this permit(IC 6-1.1-7-10(d)) ❑ State Issued Title ❑ Court Order ❑ BMV Affidavit of Sale or Disposal
INOTE: A permit to move or transfer title to a mobile home expires ninety(90)days after the date the county treasurer issues it.When the permit
i expires,it becomes invalid and the owner must obtain a new permit.
f ATTENTION: MOVER,HAULER,OR TOWER
A person who is engaged to move a mobile home may not provide that service unless the owner presents him with a permit to move the mobile home and
the permit is dated not more than ninety(90)days before the date of the proposed move.The mover shall visibly display the permit while the mobile home
is in transit.The mover must return the permit to the owner of the mobile home when the move is completed.IC 6-1.1-7-11
Name of owner's agent,if there is an agent acting on the owner's behalf I Agent's telephone number
I ( )
SECTION A-MOVING PERMIT
Name of owner Date of issuance of permit(month.day.year)
Address(number and street.city state.and ZIP code) Date permit expires(ninety(90)days after issuance)
Make of mobile home I Year Dimension Vehicle identification number
I
Address of present location(numbe-and street.city.state,and ZIP code) Affected parcel number
Address of new location(number and street.city.state and ZIP code) I Contact telephone number
Pr' y� j
___. .—_ ,,. -x_sw, 9s`-�i. -_•3u,., �� .,a.: _ r : - :a-,.�6.� .��.,-, a_�! -�Jal w*u
-
_ .
` . - - • • - •
•
PLEASE TYPE OR PRINT INFORMATION
.REQUIREMENTS: Federal and State law requires that you state the mileage In connection with the transfer of ownership. Failing to complete this form,or providing
any false statements may result in fines and/or imprisonment.
1TO SELLER: Seller is responsible for completing this form. If title is issued in more than one name,all owners listed on the title must sign ast'Seller. Do not
sign as a Seller until all areas of the assignment are completed. Any person signing on behalf of a company must state their position.
TO PURCHASER: You must apply for a new certificate of title within forty-five days of the date of purchase,or pay an administrative penalty.All liens,mortgages or
other encumbrances shown on the face of this title must be released before you apply for a new title.
I/we,as Seller,certify that to the best of my/our knowledge the information contained No
on this document is true and correct and that the odometer now reads and is the Tenths
Zip Code
❑ The odometer reading stated Is in excess of itsEl mileage
mechanical limits. WARNING ODOMETER DISCREPANCY.
Name of Dealership
- -- - Holder of lien,mortgage or encumbrance(if applicable)
Signature —
- -_. --- - Address
Printed Name
---- -- City State Zip Code
I AM AWARE OF THE ABOVE ODOMETER CERTIFICATION MADE BY THE SELLER(S)
Position Dealer Number Signature of Purchaser Printed Name of Purchaser
Date of Sale pronth,clay.yeas
SECOND RE-ASSIGNMENT BY REGISTERED DEALER ONLY
I/we,as Seller,certify that to the best of my/our 1
r Name of Purchaser Dealer Number
knowledge the information contained on this document ri Ll L I ,I -_ I I I I
is true and correct and that the odometer now reads -- - -- -
and is the ACTUAL MILEAGE of the vehide unless one Address
of the following statements is checked.
LiThe odometer reading is not actual City State ZipCode
The odometer reading stated Is in excess of its mileage
mechanical limits. WARNING ODOMETER DISCREPANCY.
Name of Dealership - Holder of lien,mortgage or encumbrance(if applicable)
Signature - Address
Printed Name City State Zip Code
-- I AM AWARE OF THE ABOVE ODOMETER CERTIFICATION MADE BY THE SELLERS)
Position Dealer Number Signature of Purchaser Printed Name of Purchaser
Date of Sale Sonic,day,year)
THIRD RE-ASSIGNMENT BY REGISTERED DEALER ONLY
I/we,as Seller,certify that to the best of my/our Name of Purchaser Dealer Number
knowledge the information contained on this document I I I II I ,I II I I..1
is true and correct and that the odometer now reads -- ----- - --------
Address
and is the ACTUAL MILEAGE of the vehide unless one
of the following statements is checked. _
EijiThe odometer reading stated is in excess of Its The odometer reading is not actual City State Zip Code
mechanical limits. E=Imileage
WARNING ODOMETER DISCREPANCY_- Holder of lien,mortgage or encumbrance(if applicable)
Name of Dealership
Signature _.- Address
- City State Zip Code
Printed Name
I AM AWARE OF THE ABOVE ODOMETER CERTIFICATION MADE BY THE SELLER(S)_
Position Dealer Number Signature of Purchaser Printed Name of Purchaser
Date of Sale(month.clay,year)
I NO ADDITIONAL-_ I
RE-ASSIGNMENTS PERMITTED
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