STATE OF INDIANA

Eric J. Holcomb, Governor Peter L. Lacy, Commissioner

SALVAGE MOTOR VEHICLE

Title Application Checklist
A salvage title is required for motor vehicles manufactured within the last seven model years that have been wrecked or
damaged. When requested, a salvage title may be issued for a vehicle over seven model years old.

Salvage title applications are processed by BMV Central Office. Prior to submitting each application, verify all required
information is included. Contact (888) 692-6841 with any questions.

When submitting paperwork, include the following:

Application for Certificate of Title for a Vehicle – State Form 205

Salvage Title Affidavit - State Form 49891

Certificate of title

o If the certificate of title is issued by a state other than Indiana, a completed Physical Inspection of
a Vehicle or Watercraft – State Form 39530 must be provided.

Proof of the date of loss provided by the insurance company (if owner of the salvage vehicle is retaining
possession of the salvage vehicle)

Submit payment for the following vehicle title application fees and taxes. Payable by MasterCard or Visa,
check, electronic check, or money order.
$4 salvage title application fee.
$10 additional administrative penalty will be assessed on a title application packet received 45
days after the purchase date. If the owner of the salvage vehicle retains possession of the
salvage vehicle, the owner must apply for a certificate of salvage title not later than 45 days after
the settlement of loss with the insurance company.
$25 speed title fee. This optional fee is in addition to the $4 salvage title application fee. Paying
the optional speed title fee ensures that the title is processed in a period of time that is
substantially shorter than the normal processing period.
If salvage vehicle is transferring ownership, include 7% sales tax of the purchase price or provide
proof of sales tax paid on an ST108- Certificate of Gross Retail or Use Tax Paid – State Form
48842. If ownership is being maintained, or if exempt from sales tax, include an ST108E –
Certificate of Gross Retail or Use Tax Exemption – State Form 44841.

Vehicle color: _______________________________ (List color on line)

For your convenience, the required forms are included with this checklist. The forms are also available at
myBMV.com. Mail the completed packet to:

Indiana Bureau of Motor Vehicles

Central Office Title Processing
100 North Senate Avenue, Room N411
Indianapolis, IN 46204

If the BMV determines that sufficient credible evidence exists to substantiate the applicant’s claim of ownership, a title will be
issued. If all required documents are not submitted or information is incomplete, the entire application will be
returned.

Please include this checklist with your application.

 APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE
State Form 205 (R9 / 7-16)
Approved by State Board of Accounts, 2016
INDIANA BUREAU OF MOTOR VEHICLES

*This agency is requesting disclosure of your Social Security Number / Federal Identification Number in accordance with IC 4-1-8-1; disclosure is mandatory, and this record cannot be
processed without it.

To be completed by a police officer, BMV official, or BMV certified dealer I swear and affirm that I am authorized to perform this transaction, and I agree
signee for out-of-state titles. I hereby certify that I personally examined the to indemnify and hold harmless the Indiana BMV from any and all liability
following vehicle and find the identification number to be as follows. arising from this transaction.

Vehicle Identification Number I swear and affirm that the information that I have entered on this form is
correct. I understand that making a false statement on this form may
constitute the crime of perjury.

Applicant Signature: _____________________________________________

Year Make Model Type Date (mm/dd/yyyy)
Printed Name: _________________________________________________
Inspector’s Printed Name and Title City Applicant Signature: _____________________________________________

Printed Name: _________________________________________________

Inspector’s Signature Badge, Branch, or Dealer Plate Number
Date (mm/dd/yyyy): ______________________________________________

Transaction Number Branch Number Invoice Number BMV Use Only

Social Security Number / Federal Identification Number * Name of Applicant BMV Use Only

Residence Address (number and street) City State ZIP Code

Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer

Former Title Number Purchase Date (mm/dd/yyyy) Lien (Y/N) Speed (Y/N) Dealer Number BMV Use Only

Holder of First Lien, Mortgage, or Other Encumbrance / Special Mailing Address Mailing Address (number and street)

City State ZIP Code BMV Use Only

Holder of Second Lien, Mortgage, or Other Encumbrance Mailing Address (number and street)

City State ZIP Code License Number License Year Forms Used BMV Use Only

Gross Retail and Use Tax Affidavit – I/We hereby certify that sales or use tax on this vehicle was paid as indicated below.
Selling Price Less Trade-In / Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code

$ $ $ $

INSTRUCTIONS: Use the following instructions to assist with completion of the application.

Sign and date on top right signature line.

Line 1: BMV use only

Line 2: Enter the name(s) and Social Security Number or Federal Identification Number of the owner(s).

Line 3: Enter the residence address of the owner(s).

Line 4: Enter the VIN, Year, Make, Model, Odometer (if applicable), and Vehicle Type (examples include: 2S (2 door sedan), 4S (4 door sedan), CN (convertible), CP (coupe), 2W (2 door wagon),
4W (4 door wagon), VA (van), TK (truck), MC (motorcycle), TR (trailer), SE (semitrailer), TC (semi tractor), RV (recreational vehicle, including motor home and travel trailer), MH (manufactured/
mobile home), AT (all-terrain), and LS (low speed).

Line 5: Enter former title number and purchase date, and indicate if there is a lien by entering Y (yes) or N (no). If a speed title is requested, enter Y (yes) and include an additional $25 with the
application.

Line 6 - 9: Indicate lienholder name(s) and mailing address. If there is no lien, and you wish to have the title mailed to an address other than your current mailing address, enter a special mailing
address on lines 6 and 7. Enter dealer license information (if applicable).

Line 10: Not required to be completed. However, appropriate tax form or payment must be included with the title application.
 SALVAGE TITLE AFFIDAVIT
State Form 49891 (R / 5-13)
INDIANA BUREAU OF MOTOR VEHICLES

INSTRUCTIONS: 1. Complete in blue or black ink or print form.

2. A certificate of salvage title is required for a motor vehicle, motorcycle, semitrailer, pursuant to the requirements as outlined in
Indiana Code §9-22-3.

SECTION 1 - OWNER INFORMATION

Owner Name(s) (last, first, middle initial or company name)

Legal Address (number and street) City State ZIP Code

SECTION 2 – INSURANCE COMPANY INFORMATION

(if applicable)
Company Name Agent Name

Address (number and street) City State ZIP Code

SECTION 3 - VEHICLE INFORMATION

Vehicle Identification Number

Vehicle Year Vehicle Make Vehicle Model

Date Vehicle Salvaged (mm/dd/yyyy) Reason

SECTION 4 – AFFIRMATION STATEMENT

I hereby request the Indiana Bureau of Motor Vehicles to issue a salvage title for the above mentioned vehicle. I certify that the vehicle
meets the salvage title requirements of Indiana Code §9-22-3-11.

I swear or affirm that the information I have entered on this form is true and correct. I understand that making a false statement may
constitute the crime of perjury. I agree to indemnify and hold harmless the Indiana Bureau of Motor Vehicles from any liability arising
from this transaction.
Signature of Owner Printed Name Date Signed (mm/dd/yyyy)
 COLLECTION OF PAYMENT INFORMATION BUREAU OF MOTOR VEHICLES
State Form 56163 (R / 9-18) Central Office Finance
INDIANA BUREAU OF MOTOR VEHICLES 100 N. Senate Avenue, Room N440
Indianapolis, IN 46204
(888) 692-6841

INSTRUCTIONS: 1. Complete in blue or black ink, or print form.

2. Enter the amount to be charged and the payment type information in Section 2. Payment may be made by Visa, MasterCard,
Discover, American Express, or electronic check. If enclosing a check, money order, cashier’s check, or certified check, this
form is not required.
3. Mail this form to the address that is specified on the application being submitted and for which you are making payment.
4. This form will be destroyed immediately after payment has been processed.

SECTION 1 - ACCOUNT HOLDER INFORMATION

Name of Account Holder (first, middle, last, or company name) Driver’s License Number (DLN) or Federal Telephone Number
Identification Number

Billing Address (number and street) City State ZIP Code

SECTION 2 - PAYMENT INFORMATION

Description of the service/application to which the payment is related:

Amount to be Charged: $ ___________. ______

CREDIT CARD PAYMENT

Type of Credit Card: Visa MasterCard Discover American Express

Credit Card Number: ____________ - ____________ - ____________ - ____________ Expiration Date (mm/yy): _____ / _____

Electronic Check Payment

Routing Number:

Account Number:

SECTION 4 - AFFIRMATION STATEMENT

I hereby authorize the Indiana Bureau of Motor Vehicles to charge the account indicated above.
Signature of Account Holder / Authorized User Printed Name Date Signed (mm/dd/yyyy)