The Missouri Lien form, officially known as Form 4809, is a document used to establish a lien on a motor vehicle. This form is essential for lienholders to protect their financial interests in the event of a loan default or bankruptcy. For detailed instructions and to complete the form, please click the button below.
The Missouri Lien form, officially known as Form 4809, is a crucial document for anyone involved in the financing or ownership of motor vehicles in Missouri. This form serves multiple purposes, including the creation of a lien, the release of an existing lien, and the authorization to add or remove names from a vehicle title. It is essential to complete the form accurately, as it requires specific information about the owner, the vehicle, and the lienholder. The owner must provide their name, address, and details about the vehicle, including the year, make, and vehicle identification number (VIN). Additionally, lienholder information must be filled out, detailing the financial institution or individual holding the lien. The form must be submitted to the Missouri Department of Revenue within 30 days of the loan date to ensure protection against potential bankruptcy claims by the debtor. A processing fee of $6.00 accompanies each submission. Failure to adhere to these guidelines can result in significant complications. Therefore, understanding the nuances of the Missouri Lien form is vital for both vehicle owners and lienholders to safeguard their interests.
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MISSOURI DEPARTMENT OF REVENUE
MOTOR VEHICLE BUREAU
573-526-3669
PO BOX 3355, JEFFERSON CITY MO 65105-3355
www.dor.mo.gov/mvdl
NOTICE OF LIEN, LIEN RELEASE, OR AUTHORIZATION TO ADD/REMOVE NAME FROM TITLE
FOR DOR USE ONLY
REJECT NUMBER
Form
4809
TYPE ALL APPLICATIONS. IF NOT
(Revised 08-2019)
TYPED, ATTACH COPY OF TITLE.
NOTICE OF LIEN (NO NOTARY REQUIRED)
IS THIS A CHANGE OF OWNERSHIP?
YES NO
OWNER INFORMATION
OWNER’S NAME (LAST, FIRST, MIDDLE) AS SHOWN ON TITLE APPLICATION (ONLY FIRST 50 CHARACTERS WILL PRINT ON TITLE)
STREET ADDRESS
COUNTY
CITY, STATE, AND ZIP CODE
DLN OR FEIN
UNIT DESCRIPTION
PASSENGER
TRUCK
ATV
TRAILER
MANUFACTURED HOME
RV
BUS
BOAT/VESSEL
OUTBOARD MOTOR (EXCLUDING TROLLING MOTOR)
MOTORCYCLE
TRICYCLE
AUTOCYCLE
YEAR
MAKE
VIN/HIN NUMBER
__ __ __ __
PURCHASE DATE
PREVIOUS TITLE NUMBER
NET PRICE (AFTER TRADE-IN)
__ __ /__ __ /__ __ __ __
LIENHOLDERFIRST INFORMATION
LIENHOLDER’S NAME AS SHOWN ON TITLE APPLICATION
FDIC OR LIENHOLDER ID NUMBER
LIEN DATE
SUBJECT TO FUTURE ADVANCES?
LOAN OR UNIT NUMBER
YES
FIRST LIENHOLDER AUTHORIZES A SECOND LIEN BY SIGNING BELOW
LIENHOLDERSECOND INFORMATION
LIENHOLDER AUTHORIZATION FOR OWNERS TO ADD/REMOVE NAME FOR TITLE. (NO NOTARY REQUIRED)
ADD/REMOVE TITLEFROMNAME
OWNER’S NAME (LAST, FIRST, MIDDLE) AS SHOWN ON TITLE APPLICATION
PRINT NAME BEING ADDED OR REMOVED
ADD REMOVE
TITLE NUMBER
PRINTED NAME OF LIENHOLDER’S AGENT
SIGNATURE OF LIENHOLDER’S AGENT
LIEN RELEASE—ATTACH TO TITLE
ANY PERSON WHO KNOWINGLY AND INTENTIONALLY SUBMITS A SEPARATE DOCUMENT
RELEASING A LIEN OF ANOTHER WITHOUT THE AUTHORITY
TO DO SO SHALL BE GUILTY OF
(NOTARY REQUIRED)
A CLASS D FELONY. (301.640 RSMo)
RELEASE/NOTARY INFORMATION
LIENHOLDER’S NAME AS SHOWN ON TITLE
NOTARY PUBLIC EMBOSSER OR BLACK
STATE
COUNTY (OR CITY OF ST. LOUIS)
LIEN CREATION DATE
RELEASE DATE
RUBBER STAMP SEAL
SUBSCRIBED AND SWORN BEFORE ME, THIS
MY COMMISSION EXPIRES
DAY OF
LIEN
NOTARY PUBLIC SIGNATURE
NOTARY PUBLIC NAME (TYPED OR PRINTED)
A $6.00 processing fee must be submitted with each Notice of Lien.
THE ORIGINAL DOCUMENT MUST BE SUBMITTED. It is recommended that you retain a copy for your records.
Form 4809 (Revised 08-2019)
NOTICE OF LIEN
PLEASE PERFECT YOUR LIEN IMMEDIATELY!
IMPORTANT: Liens must be filed and/or received with the Department within 30 days of the loan date (perfected) for the lienholder to be protected from the debtor filing for bankruptcy relief.
OWNER INFORMATION AND UNIT DESCRIPTION — Complete all applicable blocks.
FIRST LIEN — Complete the FIRST LIENHOLDER INFORMATION section, if applicable.
SECOND LIEN — Complete the FIRST and SECOND LIENHOLDER INFORMATION sections, if applicable.
First Lienholder Authorization — This block must be signed by the first lienholder when adding a second lien.
Checks may be accepted as payment. Make checks payable to: Missouri Department of Revenue. The check must be pre-printed with the check writer’s name, address, bank code, and account number. It must also include the following information regarding the check writer:
1.Driver license or non-driver license number;
2.Date of birth; and
3.Daytime phone number.
Other restrictions may apply. NOTE: The Missouri Department of Revenue may electronically resubmit checks returned for insufficient or uncollected funds.
The lienholder will receive a receipt as proof the lien has been perfected.
Submit the completed Notice of Lien (Form 4809) to your local license office or by mail to the following address:
301 WEST HIGH STREET
PO BOX 3355
JEFFERSON CITY MO 65105-3355
LIEN RELEASE
OWNER INFORMATION AND UNIT DESCRIPTION SECTIONS — Complete all applicable blocks.
FIRST AND SECOND LIENHOLDER SECTIONS — Leave blank.
LIEN RELEASE SECTION — Enter the lienholder’s name as shown on title, the date of release, printed name of the lienholder’s agent, and signature of lienholder’s agent.
NOTARIZATION — The notary information is required to be completed to release the lien.
NOTE: License Office notary service - $2.00
FRAUDULENT LIEN RELEASE — ANY PERSON WHO KNOWINGLY AND INTENTIONALLY SUBMITS A SEPARATE DOCUMENT RELEASING A LIEN OF ANOTHER WITHOUT THE AUTHORITY TO DO SO SHALL BE GUILTY OF A CLASS D FELONY. (301.640, RSMo)
Form 4809 (08-2019)
Titling a Car in Missouri - Form 5429: Missouri's temporary license plate application, involving a precise process for vehicle owners.
941 Vs 943 - To protect taxpayer information and maintain integrity, a perjury statement is required, underlining the seriousness of the information provided.