The 2519 Missouri form is a document used to request a receipt for title and/or registration from the Missouri Department of Revenue's Motor Vehicle Bureau. This form serves as proof of payment and is essential for individuals who have lost, stolen, mutilated, or destroyed their vehicle title or registration. To ensure compliance, applicants must complete the form in full and have it notarized before submission.
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The Form 2519, issued by the Missouri Department of Revenue, serves as a crucial document for individuals seeking proof of payment related to motor vehicle title and registration. This form is specifically designed for owners who have lost, stolen, mutilated, or destroyed their title or registration receipts. It is important to note that this receipt is not a duplicate title; for that, applicants must refer to Form DOR-108. The application process requires the owner or joint owner of the vehicle to complete the form in full, ensuring all information is legible and accurate. A notary public must witness the signature, reinforcing the form's validity. The form collects essential details, including the owner's legal name, address, and vehicle information such as the make, year, and identification number. Applicants must also be aware of the associated fees, which total $8.50 for each receipt, along with a $3.50 processing fee. Upon completion, the form should be mailed to the Motor Vehicle Bureau or submitted at a contract office, accompanied by the appropriate payment. For any inquiries, the Motor Vehicle Bureau provides assistance via phone and through its website.
MISSOURI DEPARTMENT OF REVENUE MOTOR VEHICLE BUREAU
REQUEST FOR RECEIPT OF TITLE AND/OR REGISTRATION
FORM
2519
(REV. 3-2011)
THIS RECEIPT IS FOR PROOF OF PAYMENT ONLY. TO APPLY FOR A DUPLICATE TITLE,
PLEASE SEE FORM DOR-108, APPLICATION FOR MISSOURI TITLE AND LICENSE .
TYPE
TITLE RECEIPT (SHOWING TAX PAID)
REGISTRATION RECEIPT
(SHOWING PURCHASE OF LICENSE)
REASON REQUIRED:
LOST
STOLEN
MUTILATED
DESTROYED
VALIDATION
OWNER’S LEGAL NAME
STREET ADDRESS, R.R. OR P.O. BOX
COUNTY
CITY
STATE
ZIP CODE
__ __ __ __ __
VEHICLE INFORMATION
YEAR
MAKE
VEHICLE IDENTIFICATION NUMBER
__ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
KIND OF VEHICLE
LICENSE PLATE NUMBER
TITLE NUMBER
__ __ __ __ __ __
ANY FALSE STATEMENT IN THIS APPLICATION IS A VIOLATION OF THE LAW AND MAY BE PUNISHED BY FINE OR IMPRISONMENT OR BOTH. FORM MUST BE COMPLETED IN FULL AND NOTARIZED.
I HEREBY MAKE APPLICATION FOR A TITLE/REGISTRATION RECEIPT. I CERTIFY THAT I AM THE OWNER OR JOINT OWNER OF THE VEHICLE DESCRIBED ABOVE.
SIGNATURE OF OWNER
DATE
__ __ /__ __ / __ __ __ __
NOTARY INFORMATION
SUBSCRIBED AND SWORN BEFORE ME THIS
DAY OF
NOTARY PUBLIC NAME (TYPE OR PRINTED)
NOTARY PUBLIC SIGNATURE
MY COMMISSION
EXPIRES
NOTARY PUBLIC EMBOSSER SEAL
COUNTY (OR CITY OF ST. LOUIS)
USE RUBBER STAMP IN CLEAR AREA BELOW.
MO 860-0378 (3-2011) DISTRIBUTION: WHITE—OFFICE YELLOW—AUDIT PINK—CUSTOMER
INSTRUCTIONS TO APPLICANT
1.This receipt is for proof of payment only. To apply for a duplicate title, please see Form DOR-108, Application for Missouri Title and License.
2.Only the owner or the joint owner of a motor vehicle may apply for a title/registration receipt.
3.The application must be completed in full and signed before a notary public. It should be typewritten or printed legibly. (Print so that all copies are legible.)
4.Fees — The total fees for a title/registration receipt is $8.50 for each receipt made and a $3.50 processing fee.
NOTE: THE MISSOURI DEPARTMENT OF REVENUE MAY ELECTRONICALLY RESUBMIT CHECKS RETURNED FOR INSUFFICIENT OR UNCOLLECTED FUNDS.
5.When this application is completed, it must be mailed to the MISSOURI DEPARTMENT OF REVENUE, MOTOR VEHICLE BUREAU, POST OFFICE BOX 100, 301 W HIGH ST, JEFFERSON CITY MISSOURI 65105-0100 or taken to a contract office. If mailing the application to the Motor Vehicle Bureau, a check or money order (DO NOT SEND CASH) for the correct amount made payable to the Missouri Department of Revenue must accompany the application. If you have any questions, please call the Motor Vehicle Bureau at (573) 526-3669.
Our web site address is www.dor.mo.gov.
MO 860-0378 (3-2011)
DOR-2519 (3-2011)
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