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Instructions
This form must be completed when a vehicle is repossessed. All fields are required to be completed. Select the applicable Method
of Repossession and attach any required documentation, if applicable. This completed form must be submitted to a county tax
assessor-collector's office in addition to all other required documents at the time of title transfer.
Vehicle Information
Vehicle Identification Number Year Make Body Style Model
Lienholder Information
Name of Lienholder Phone Number Date of Repossession
A floor plan lien covers vehicles in a dealers inventory. If the dealer is in default under the terms of the security
agreement, the lienholder may repossess and transfer ownership without securing title in the dealers name. In such
instances, an Application for Texas Title and/or Registration (Form 130-U) in the name of the purchaser must be
supported by the following documentation:
Manufacturers Certificate of Origin or Certificate of Title properly assigned to the dealership and reassigned to
the purchaser by the lienholder, and
Security Agreement or UCC Financing Statement (Form UCC1).