STATE OF INDIANA

Michael R. Pence, Governor

Kent W. Abernathy, Commissioner

MUNICIPAL CORPORATION AND LAW ENFORCEMENT

Vehicle Title and Registration Application Checklist
Title and registration applications for municipal corporations, including law enforcement, must be processed by the BMV
Municipal Processing department. Prior to submitting each application, verify all required information is included.
Contact (888) 692-6841 with any questions.
When submitting paperwork, include the following:
Title Application Requirements
Application for Certificate of Title for a Vehicle State Form 205
Original certificate of title or manufacturers certificate of origin
Physical Inspection of a Vehicle or Watercraft State Form 39530. Required for vehicles purchased outside of
Indiana.
Odometer Disclosure Statement State Form 43230 (if odometer statement is not completed on the certificate
of title or certificate or origin). Trailers and vehicles over 16,000 pounds are exempt.
ST108E Certificate of Gross Retail or Use Tax Exemption State Form 48841
$15.00 title application fee. A $21.50 administrative penalty will be assessed if the title application packet is not
received within 45 days after the date of purchase. Payable by MasterCard or Visa, check, electronic check, or
money order.
Registration Application Requirements
Application for New and/or Transferred License Plates for Municipal Corporations and Law Enforcement
State Form 53565
Copy of Indiana certificate of title or Application for Certificate of Title for a Vehicle State Form 205 (if already
titled to applicant)
Copy of the lease agreement or Statement of Existing Lease Agreement State Form 12787 (if the vehicle is
being leased from a leasing company)
Safety inspection completed by ISP for all municipally owned school buses

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 Municipal Processing
100 North Senate Avenue, Room N415
Indianapolis, IN 46204
If the BMV determines that sufficient credible evidence exists to substantiate the applicants claim of ownership, a
title/registration will be issued. If all required documents are not submitted or information is incomplete, the entire
application will be returned.
Please include this checklist and contact information with your application.
Print Name: ___________________________________________________________________________________
Phone Number: __________________________ Email: _______________________________________________

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.

I swear and affirm that I am authorized to perform this transaction, and I agree
to indemnify and hold harmless the Indiana BMV from any and all liability
arising from this transaction.

To be completed by a police officer, BMV official, or BMV certified dealer

signee for out-of-state titles. I hereby certify that I personally examined the
following vehicle and find the identification number to be as follows.

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.

Vehicle Identification Number

Year

Make

Model

Type

Applicant Signature: _____________________________________________

Date (mm/dd/yyyy)

Printed Name: _________________________________________________

Inspectors Printed Name and Title

Inspectors Signature

City

Applicant Signature: _____________________________________________

Printed Name: _________________________________________________

Badge, Branch, or Dealer Plate Number

Date (mm/dd/yyyy): ______________________________________________

Transaction Number

Branch Number

Social Security Number / Federal Identification Number *

Name of Applicant

Invoice Number

BMV Use Only

BMV Use Only

Residence Address (number and street)

City

Vehicle Identification Number

Vehicle Year

Vehicle Make

Former Title Number

Purchase Date (mm/dd/yyyy)

State

Vehicle Model

Lien (Y/N)

Speed (Y/N)

Vehicle Type

Dealer Number

Holder of First Lien, Mortgage, or Other Encumbrance / Special Mailing Address

Mailing Address (number and street)

City

ZIP Code

State

Holder of Second Lien, Mortgage, or Other Encumbrance

City

State

ZIP Code

Odometer

BMV Use Only

BMV Use Only

Mailing Address (number and street)

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.

PHYSICAL INSPECTION OF A VEHICLE OR WATERCRAFT

State Form 39530 (R5 / 12-11)

Approved by State Board of Accounts, 2011

INDIANA BUREAU OF MOTOR VEHICLES

INSTRUCTIONS:

1. Approved inspector must complete information in blue or black ink or print form.
2. The vehicle identification number (VIN) or hull identification number (HIN) must be inspected to verify the existence and condition
of the number. An ownership document is not required to be submitted for inspection.
3. Inspections may be performed by an employee of a dealer designated by the Indiana Secretary of State, a military policeman
assigned to a military post in Indiana, a police officer, or a designated employee of a BMV full or partial service license branch.
4. Police officers completing this form may not charge a fee of more than $5.00 for vehicles. No fee may be collected for watercraft
inspections. Authorized Indiana dealers and BMV full or partial service license branches may not assess a fee.
5. Dealers may not perform watercraft inspections.

OWNER INFORMATION
Name (last, first, middle initial or company name

Address (number and street)

City

State

ZIP Code

VEHICLE OR WATERCRAFT INFORMATION

NONE (select if no identification number found)

Identification Number

Year

Make

Model

Type

Plate Number / State

Watercraft Registration
Number, if applicable

For assembled vehicles or watercraft include serial numbers for major component parts if present:
Engine / Motor

Transmission

Body Chassis

Front Assembly

Rear Clip

Frame

Other (specify):

*IDACS / NCIC Check (required if form is completed by a police officer)

Date Check Performed (mm/dd/yyyy)

Comments

I swear or affirm that the information I have entered on this form is correct. I understand making a false statement may
constitute the crime of perjury.
Signature of Inspector

Printed Name

Title

Date (mm/dd/yyyy)

Badge / Branch / Dealer Number

Police Department / Branch / Dealership

City

ZIP Code

Telephone Number

Email Address

ODOMETER DISCLOSURE STATEMENT

State Form 43230 (R3 / 5-13)
INDIANA BUREAU OF MOTOR VEHICLES

INSTRUCTIONS:

1.

2.
3.

In accordance with federal and state law, the seller of a motor vehicle must disclose the current mileage to a purchaser in
writing upon transfer of ownership. The disclosure must be signed by the seller, including the printed name. If more than one
person is a seller, only one seller is required to sign the written disclosure.
The purchaser must sign the disclosure statement, including printed name and address, and return a copy to the seller.
Complete this form in its entirety, in blue or black ink.

Federal and State law requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false
statement may result in fines, imprisonment, or both.
I, __________________________________________________________________________________________ residing at:
Printed name(s) of Seller(s)
_______________________________________________________________________________________ certify
Address of Seller(s) (number and street, city, state, and ZIP code)

to the best of my knowledge that the

odometer reading is the actual mileage of the vehicle described below unless one of the following statements is checked:

Miles (no tenths)

Vehicle Make

1.

I hereby certify that to the best of my knowledge the odometer reading reflects the amount of
mileage in excess of its mechanical limits.

2.

I hereby certify that the odometer reading is NOT the actual mileage and should not be relied upon.
WARNING - ODOMETER DISCREPANCY.

Vehicle Model

Vehicle Year

Vehicle Body Type

Transfer Date (month, day, year)

Vehicle Identification Number (VIN)

I will not hold the Bureau of Motor Vehicles or the Bureau of Motor Vehicles Commission responsible for any discrepancy shown on
the odometer reading. I, the undersigned, swear or affirm that the information entered on this form is correct. I understand that
making a false statement may constitute the crime of perjury.
Signature(s) of Seller(s)

Date (month, day, year)

PURCHASERS INFORMATION
I am aware of and acknowledge the above odometer certification made by the seller(s).
Signature(s) of Purchaser(s)

Date (month, day, year)

Printed Name(s) of Purchaser(s)

Address of Purchaser(s) (number and street)

City

State

ZIP Code

Indiana Department of Revenue

Certificate of Gross Retail or Use Tax
EXEMPTION for the Purchase of a
Motor Vehicle or Watercraft

Form

ST-108E
State Form 48841
(R4 / 3-08)

Dealers RRMC # (Registered Retail Merchant Certificate Number)

NAME OF DEALER

TID# (10 digits)

Dealers FID # (Federal Identification Number, 9 digits)

LOC# (3 digits)

Dealers License Number (seven digits)

Address of Dealer

City

State

NAME OF PURCHASER(S) (PRINT OR TYPE)

Address of Purchaser

City

Zip Code

SSN, TID, OR FID # (Mandatory)

State

Zip Code

Vehicles Identification Information of Purchase

VIN # (Vehicle Identification Number) or HIN # (Hull Identification Number)

Year

Calculation Of Purchase Price

Make

Model/Length

Trade in Information

1. Total Purchase Price .........................

1.

VIN # (Vehicle Identification Number) or HIN # (Hull Identification Number)

2. Trade-Allowance
(Like-kind exchanges only)................

2.

Year

Make

Model/Length

3. Net Purchase Price

(Line 1 minus Line 2) ...............................3.
CALCULATION Of PURCHASE PRICE LINES 1, 2 & 3 MUST BE COMPLETED FOR ALLEXEMPTED PURCHASES
NEW RESIDENT STATEMENT Must Be Completed if Exemption # 8 is claimed, see reverse side.
I certify that I became a resident of INDIANA on (month & year)
.
My previous State of Residence was
Date

. I hereby certify that the above statement is true and correct.

Signature of owner

SALES/USE Tax WORKSHEET To be completed if Sales and/or Use Tax was paid to a state other than Indiana, Exemption # 15. See reverse
side. Date of Purchase
1. Purchase price of property subject to sales/use tax.......................................................................... 1. $
2. Indiana sales/use tax due: Multiply Line 1 by sales/use tax percentage (7%)....................................... 2.
3. Credit for sales tax previously paid to another state .......................................................................... 3.
(Do not include flat fees, local, and/or excise taxes.) In what state was the tax paid?
4. Total amount due: Subtract Line 3 from Line 2.................................................................................. 4. $
(Line # 3 cannot exceed Line # 2)
DIRECT RELATIVE IDENTIFICATION EXEMPTION (Must Be Completed if Exemption # 11 is claimed, see reverse side).
Name(s) on original title

Relationship of above parties

Name(s) being added/deleted

PUBLIC TRANSPORTATION EXEMPTION (Must be completed if exemption # 6 is claimed and you are not a school bus operator.)
USDOT # (U.S. Department of Transportation Number)
I certify that the above vehicle or watercraft is exempt from sales/use tax under exemption #
(see reverse side). I also certify
that any sales tax credit shown as paid to an out of state dealer using exemption #15 was actually collected by the dealer and the dealer has
not provided the buyer with a check to be paid to the BMV. I understand that making a false statement on this form may constitute the crime
of perjury.
Date

Signature of Purchaser

GENERAL INFORMATION
INDIANA CODE 6-2.5-9-6 requires that a person titling a vehicle or watercraft present certification indicating the state gross sales and use
tax has been paid; otherwise, the payment of the tax must be made directly to a Bureau of Motor Vehicles license branch.
If NONE of the exemptions apply to the purchase, Form ST-108 must be completed by the dealer and the purchaser to indicate that
the sales/use tax was collected by the dealer. The dealer is then required to submit the sales/use tax to the Department of Revenue.
a purchasers ID# (SSN-Social Security #, TID - Indiana Taxpayer Identification #, FID - federal Identification #) is
mandatory to claim an exemption. Calculation of Purchase Price lines #1, #2 and #3 must be completed for all exempted
purchases. The exemption claim is not valid without providing a required ID# and Purchase Price information. Exemptions
available are:
1. Vehicles or watercraft purchased by Indiana or Federal governmental units or their instrumentalities.
2. Vehicles or watercraft purchased by nonprofit organizations operated exclusively for religious, charitable, or educational
purposes and using the vehicle for the purpose for which such organization is exempt. The applicant MUST indicate its 13
digit Indiana TID and LOC number on the front of the form. The nonprofit name must be on the title to claim this
exemption.
3. Issue title for the sole purpose of adding lien holder information. This exemption is not available to add, delete, or change the
name on a title.
4. Trucks, not to be licensed for highway use, and to be directly used in direct production of manufacturing, mining, refining or
harvesting of agricultural commodities. Ready-mix concrete trucks are exempt under this paragraph even though they are to
be licensed for highway use. Vehicles registered with farm plates are not exempt.
5. Sales of motor vehicles or watercraft to Registered Retail Merchants acquiring the vehicles or watercraft to rent, or lease to
others and whose ordinary course of business is to rent or lease vehicles or watercraft to others.
6. Vehicles or watercraft to be predominately used for hire in public transportation. (Hauling for hire.) Your USDOT number must
be shown on the reverse side of this form. Predominate use is greater than 50%.
7. Vehicles or watercraft transferred from one individual to another with no consideration involved or received as outright gift or
inheritance. Assumption of loan payments by the purchaser constitutes consideration and is therefore NOT exempt unless
the transferred party was listed on the original security agreement. A copy of the original security agreement must be
submitted with the title paperwork.
8. Vehicles previously purchased, titled and licensed in another State or Country by a bonafide resident of that State or Country,
who subsequently has become an Indiana resident, are exempt from Indiana sales/use tax upon titling and registration of
the vehicle in Indiana. Watercraft previously purchased, titled, or licensed in another state, by a bonafide resident of that
state, who subsequently has become an Indiana resident, are exempt from sales/use tax upon titling or registration of the
watercraft in Indiana. The New resident Statement on the front of the form MUST be completed.
9. Vehicles or watercraft purchased to be immediately placed into inventory for resale. NonIndiana dealers must enter both their
FID number and their states Dealer License Number on this form in lieu of the Indiana TID number if they are not
registered with the Indiana Department of Revenue. Note: Motor vehicle dealers are only exempt from sales tax on new motor
vehicles purchased for which they possess a manufacturers franchise to sell that particular vehicle. If a dealer does not possess a
manufacturers franchise to sell the new vehicle purchased the dealer must pay sales tax and the resale exemption is invalid. (I.C.
6-2.5-5-8)
10. Vehicles or watercraft, not to be licensed for use, which are eligible for a repossession title issued by the State of Indiana as a
result of a bonafide credit transaction or salvage title resulting from an insurance settlement.
11. Transactions consisting of adding or deleting a spouse, child, grandparent, parent, or sibling of the owner of a motor vehicle
only per 6-2.5-5-15.5. The Direct Relative Identification Statement on the front of the form MUST be completed.
12. Vehicles or watercraft won as a prize in a raffle or drawing which were previously titled by a qualified nonprofit organization.
A valid Federal Miscellaneous Income Statement, Form 1099-MISC or an affidavit completed by the nonprofit organization
must be submitted with the title paperwork in order for this exemption to be claimed. The affidavits must state the nonprofit
organization name and exemption number, the winners name, address and social security number and the fair market value
of the vehicle awarded as the prize.
13. Redemption of repossessed vehicles or watercraft by the original owner.
14. Indiana Department of Revenue use only. This exemption may not be used unless authorized by the Department by calling
(317) 233-4017. A complete copy of each transaction claiming this exemption must be sent to IDOR, Compliance Division.
15. Sales tax paid to a non-BMV licensed dealer. The seller may be either an Indiana seller or an out of state seller. This amount
will be used as a nonrefundable credit against the amount of Indiana sales tax due.

This agency is requesting the disclosure of your Social Security number in accordance with IC 4-1-8-1.
Disclosure is mandatory; this record cannot be processed without it.

APPLICATION FOR MUNICIPAL CORPORATION

AND LAW ENFORCEMENT LICENSE PLATES

BUREAU OF MOTOR VEHICLES

Municipal Processing
100 North Senate Avenue
Room N415
Indianapolis, IN 46204

State Form 53565 (R4 / 4-15)

Indiana Bureau of Motor Vehicles

INSTRUCTIONS:

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

2. Complete all information in sections 1, 2, 3, and 4, as applicable, and mail to the address listed above.
3. The application must be accompanied by a copy of each vehicle title, title application, or lease agreement if applying for
registration only.
4. For a new license plate request, choose either the license plate type that is reflective of your entity, a standard passenger
license plate, or other license plate type desired.
5. Indicate in Section 3 which of the municipal classifications applies to the entity named on this application. The entity must
submit the requested documentation or proof that the entity meets the indicated classification.
6. A safety inspection must be completed by the Indiana State Police for all school bus plate applications.

SECTION 1 - APPLICANT INFORMATION

Name of Owner

Federal Identification Number

Street Address of Entity (number and street)

City

State

ZIP Code

County

Township

IN
Mailing Address (if different from street address)

City

State

ZIP Code

IN
Name and Title of Entitys Executive Officer

Telephone Number

SECTION 2 - VEHICLE INFORMATION

(List the following information for each vehicle. Attach additional sheets if necessary.)
Purchase or Lease Date (mm/dd/yyyy)

(1) Vehicle Identification Number (VIN): (Please enter in spaces below.)

Year

Make

Model

Type

Description of Vehicle Official Business Usage (Law Enforcement Agency

must include here if tactical or non-tactical vehicle.)

Color

Gross Vehicle Weight (if applicable)

Financial Responsibility (Source of self-insurance or insurance company

name and policy number)

The application is for: (check one)

License Plate Type: (check one)

City Police

New License Plate

Sheriff

State Owned University

Municipal

School Bus

Driver Education

Law Enforcement Administrative

Transfer an Existing License Plate:

(plate number)

Or you may choose one of the following:

Passenger

Other:
(enter plate type)

Page 1 of 3

Purchase or Lease Date (mm/dd/yyyy)

(2) Vehicle Identification Number (VIN): (Please enter in spaces below.)

Year

Make

Model

Type

Description of Vehicle Official Business Usage (Law Enforcement Agency

must include here if tactical or non-tactical vehicle.)

Color

Gross Vehicle Weight (if applicable)

Financial Responsibility (Source of self-insurance or insurance company

name and policy number)

The application is for: (check one)

License Plate Type: (check one)

City Police

New License Plate

Sheriff

State Owned University

(plate number)

Other:
(enter plate type)
Purchase or Lease Date (mm/dd/yyyy)

(3) Vehicle Identification Number (VIN): (Please enter in spaces below.)

Model

Type

Description of Vehicle Official Business Usage (Law Enforcement Agency

must include here if tactical or non-tactical vehicle.)

Color

Gross Vehicle Weight (if applicable)

Financial Responsibility (Source of self-insurance or insurance company

name and policy number)

The application is for: (check one)

License Plate Type: (check one)

City Police

New License Plate

Sheriff

State Owned University

(plate number)

School Bus

Driver Education

Or you may choose one of the following:

Passenger

Other:
(enter plate type)
Purchase or Lease Date (mm/dd/yyyy)

(4) Vehicle Identification Number (VIN): (Please enter in spaces below.)

Make

Municipal

Law Enforcement Administrative

Transfer an Existing License Plate:

Year

Driver Education

Or you may choose one of the following:

Passenger

Make

School Bus

Law Enforcement Administrative

Transfer an Existing License Plate:

Year

Municipal

Model

Type

Description of Vehicle Official Business Usage (Law Enforcement Agency

must include here if tactical or non-tactical vehicle.)

Color

Gross Vehicle Weight (if applicable)

Financial Responsibility (Source of self-insurance or insurance company

name and policy number)

The application is for: (check one)

License Plate Type: (check one)

City Police

New License Plate

Sheriff

State Owned University

Municipal

School Bus

Driver Education

Law Enforcement Administrative

Transfer an Existing License Plate:

(plate number)

Or you may choose one of the following:

Passenger

Other:
(enter plate type)

Page 2 of 3

SECTION 3 - ENTITY CLASSIFICATION

Please check one (1):
1. The State of Indiana
a) a state agency
b) a state university
c) other state entity
2. A municipal corporation (as defined in IC 36-1-2-10) "Municipal corporation" means any of the following:
a) a county, city, town, or township
b) school corporation (Must be listed as a school corporation with the Indiana Department of Education)
c) library district (Must be listed as a library with the Indiana State Library)
d) local housing authority (Must provide a certified copy of the ordinance(s) that establishes the authority)
e) fire protection district (Must be listed with the Indiana State Fire Marshall or Indiana Department of Homeland Security)
f) public transportation corporation (Must provide a certified copy of the ordinance(s) that establishes the corporation)
g) local building authority (Must provide a certified copy of the resolution or ordinance(s) that establishes the authority)
h) local hospital authority or corporation (Must provide a certified copy of the resolution or ordinance(s) that establishes the authority)
i) local airport authority (Must provide a certified copy of the resolution or ordinance(s) that establishes the authority)
j) special service district (Must provide a certified copy of the resolution or ordinance(s) that establishes the district)

3.

k) other separate local governmental entity that may sue and be sued (Must provide a certified copy of the statute, ordinance or resolution
that establishes the entity).
A volunteer fire department (as defined in IC 36-8-12-2) (Must be listed with the Indiana State Fire Marshall or Department of Homeland
Security and provide a copy of the contract or resolution to provide firefighting services for a county, city, town, or township.)

4.

A volunteer emergency ambulance service that meets the requirements of IC 16-31 and has only members that serve for no
compensation or a nominal annual compensation of not more than $3,500.00. (Must be registered as a Volunteer Emergency Ambulance
Service with the Indiana Emergency Medical Services and provide an official letter from the Indiana Emergency Medical Services Commission.)

5.

A rehabilitation center funded under IC 12-12 (Must be listed as rehabilitation center with the Indiana Rehabilitation Bureau and provide a
letter from the Indiana Rehabilitation Bureau of the FSSA.)

6.

A community action agency (IC 12-14-23) (Must be designated by the Governor or under Federal law as a community action agency.)

7.

An area agency of aging and the aged (IC 12-10-1-6) and a county council on aging that is funded through an area agency (Must
provide a copy of the contract with the Bureau of Aging and In-Home Services.)

8.

A community mental health center (IC 12-29-2) (Must provide a copy of the Division of Mental Health and Addictions certificate to operate in
Indiana as a community mental health center.)

For Law Enforcement License Plates (only available to these entities pursuant to IC 9-18-3-6): (Must provide official identification showing the
representative is employed with the entity.)
a) The Indiana State Police Department
b) A county police department
c) A city or town police department

SECTION 4 - AFFIRMATION AND SIGNATURE

The authorized representative submitting this application swears or affirms under the penalty of perjury that the information provided in this application is true
and correct, that the entity for which this application is made owns or leases the above listed vehicle(s) and uses it for official business pursuant to IC 9-18-31.
Signature of Authorized Representative
Printed Name of Representative
Date (mm/dd/yyyy)
Title of Representative

Telephone Number of Representative

(
)

Page 3 of 3

Payment Information
Pay by:
Check or money order
Credit Card (MasterCard or Visa)
Electronic check

I hereby authorize the Indiana Bureau of Motor Vehicles to

charge the credit card indicated below:
Type of card:

MasterCard

Visa

Name of cardholder:
Account
Number:
Expiration
Date:

I hereby authorize the Indiana Bureau of Motor Vehicles to charge the checking
account indicated below:
Routing Number

Account Number