STATE OF WYOMING 
                                                      Application for Certificate of Title and VIN/HIN Inspection Form 
                                                                  (Proof of ownership MUST                    accompany application)  
         Motor Vehicle                Trailer                 Snowmobile                      Watercraft                    Mobile Home                                                                 Date Title Issued: _________________ 
                                                                                                         
    MANUFACTURER                       YEAR                       VEHICLE /HULL           IDENTIFICATION NO.                                                                                         NMVTIS        BODY STYLE 
                                                                                                                                                                                                                   
    FACTORY PRICE /               STATE                 PRIOR TITLE NO.                           ODOMETER                   WEIGHT                                                                  PURCHASE DATE     VESSEL LENGTH 
           MSRP 
                                                                                                                                                                                                                       
                                                BRANDED TITLE INFORMATION –definitions and requirements are on the reverse side of this application. 
   
  Does    this motor vehicle currently have or ever had a branded title?            Yes          No     If yes, what brand? _________________________________________________________ 
  Has this motor vehicle been declared a total loss by an insurance company or sustained 75% damage of actual cash value?            Yes          No 
  Print name of person completing this section: ____________________________________     Signature: X___________________________________________________________ 
  
 PURCHASER / SELLER INFORMATION (Please print clearly)                                                                                                                                                                   Joint Tenants  
                                                                                                                                                                                                                         With Rights of  
       NAME OF PURCHASER(S)                                                                                                                                                                                                   Survivorship? 
      ADDRESS                                                                                               CITY                                                                                            STATE    ZIP                         
      N A M E  O F  S E L L E R                                                                                                                                                                                                                 
       ADDRESS                                                                               CITY                                                  STATE____________    ZIP_______________ 
  
 LIEN INFORMATION (Please print clearly) 
       N A M E  O F  L IE N  H O L D E R                                                                                                                                                                                                       
      ADDRESS                                                                                               CITY                                                                                            STATE    ZIP                         
      LIEN FILING #                                                            FILING DATE                                                     LIEN AMOUNT                                                                                       
  
 I/WE HEREBY SWEAR OR AFFIRM under penalty of perjury that all information on this application is true and correct and that I/we am/are lawfully applying for a Wyoming Certificate 
 of Title.  I/we further warrant that said vehicle is owned by me/us and is subject to the liens shown and none other.  I/we further certify to the best of my/our knowledge that if the vehicle 
 is a mobile home, all taxes due on the mobile home for the preceding and current year have been paid and in the event taxes have not been paid, acknowledge that I/we may be 
 responsible for the taxes for the preceding and current year.  Any false information may cancel the title and void any registration associated with the title. 
  
 PURCHASER SIGNATURE(S):__X_______________________________________________________  __X_______________________________________________________  
                                                                                                   
 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 
 NOTARY STATEMENT (Required on all applications                )                                                                                                                                       
  
 STATE    OF                                                                                                                                                                    (Seal) 
 COUNTY    OF                                        
 Subscribed and sworn to before me by                                                                                                    this                                                           day of                , 20                   
            
 Office of County Clerk or Notary Signature                                                                                                  My Commission Expires:                                                                            
  ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~“V I N” or “H I N” Inspection Form~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 
                      REQUIRED WHEN THE PRIOR TITLE IS FROM A STATE OTHER THAN WYOMING.  NOT REQUIRED FOR MSO/MCO. 
 ** Before completing the V.I.N. or H.I.N. inspection, please review the “NOTICE” on the reverse side or this form to determine if you are authorized by 
 statute to do so.  Please print the vehicle/watercraft information as accurate and legible as possible and then verify with your signature at the bottom. 
           AUTHORIZED AGENT  
          PRINT   VIN OR HIN HERE   _____                 _____   _____   _____   _____   _____   _____   _____   _____  _____   _____   _____   _____   _____   _____  _____  _____ 
                                                      Vehicle Identification Number (VIN) typically contain 17 alpha-numeric characters and 
                                  Hull ID Number (HIN) HIN’s are required to have 10-14 but typically have 12 alpha-numeric digits, with no spaces or dashes. 
                                                                                                         
 Year:                   Make:                                Model:                                         Trim:                               VIN / HIN Verified With NCIC?     Yes  /  No 
                                             (Ford, Jeep, Chevy, Honda, etc.)                          (F-150, Camaro, Wrangler, etc.)                   (XLT, Lariat, GT, LS, Rubicon, etc.)                                    Circle One      
  
 Subject to the penalties of perjury,    I,                                                                              B A D G E /T IT L E /D L R  N U M B E R                                     :                                    am 
  
 an authorized member or employee of, AGENCY orENTITY NAME:                                                                                                                                                                                   
                                                (Please Circle One)        Police Dept.   /    Sheriff’s Office   /    Highway Patrol   /    State Police   /     G&F    /   Other Entity:                                                                 
  
 depose and state that, I personally inspected the VIN or HIN in the state of                                        on the above described vehicle/watercraft and the information entered by 
 me is true and correct.  The undersigned verifies that I am authorized by the laws of Wyoming (or state where the inspection occurred), to conduct this inspection.                            
  
 Signature:           Date:    Phone:                                                                                                                                                                                                         
     W.S. 31-3-102(b) provides a $10.00 fee for each vehicle identification number inspected, and one $10.00 fee for inspection of a VIN and HIN at the same time, pursuant to W.S. 31-2-103(a)(vi). 
  
 MV-300A (01/18) 
  

NOTICE:  The person conducting the VIN  (vehicle) or HIN (watercraft) identification number inspection SHALL be authorized by 
their state statute regarding inspections of this nature.  Any person who conducts a VIN or HIN inspection and is not lawfully 
authorized to do so shall be cause to void the title application and may void any title or registration issued that is related to this 
VIN or HIN   inspection.  In addition, YOU MAY BE SUBJECT TO CRIMINAL PENALTIES.     (A VALID HIN on a watercraft is 
required  to have 10-14 alpha-numeric digits but typically has 12, with no spaces or dashes.) 
                                       Wyoming V.I.N. Inspection Statutes 
                                                            
  W.S. 31-2-103.  Contents of application; signature; vehicle identification number; issuance of 
certificate. 
   
  (a)   (vi)  In the case of a vehicle registered or titled in a state other than Wyoming, or any 
homemade vehicle, rebuilt vehicle, reconstructed vehicle, any vehicle assembled from a kit or any vehicle 
for which a bond is required, a current statement made by a Wyoming law enforcement officer,   or licensed 
Wyoming dealer only for vehicles in his inventory or possession, that the vehicle identification number on 
the vehicle has been inspected and that the inspection occurred in Wyoming and certifying the correct 
vehicle identification number displayed on the vehicle.  Any licensed Wyoming dealer performing an 
inspection of a vehicle identification number under this section shall, in addition to the requirements of 
this act, do so pursuant to W.S. 31-11-108. In the case of a vehicle not in Wyoming, the vehicle 
identification number may be inspected and certified on a form approved by the department if the 
inspection is made by an authorized law enforcement officer of a city, county or state law enforcement 
agency or a commissioned officer at a federal military installation or any other person authorized to do 
so by law and delivered to the county clerk in the county where the application for certificate of title 
is made along with payment for the inspection fee required under W.S. 31-3-102(b)(iv); 
   
           (ix)  Such other information as required by the department or county clerk which may include but 
not be limited to a vehicle bill of sale or similar document, any documentation necessary to verify proof 
of ownership including an affidavit for proof of ownership or any surety bond required by this act.  Any 
affidavit for proof of ownership shall be prescribed pursuant to W.S. 31-1-201(d) and shall be utilized by 
each county of this state; 
           
           (x)  A Wyoming certificate of title shall contain an appropriate notice whenever records readily 
accessible to the state indicate that the motor vehicle was previously issued a title or registration from 
any jurisdiction that bore any word or symbol signifying that the vehicle was "salvage", "unrebuildable", 
"parts only", "scrap", "junk", "nonrepairable", "reconstructed", "rebuilt" or any other symbol or word of 
like kind, or that it has been damaged by flood.  Any information concerning a motor vehicle's status 
shall also be conveyed on any subsequent title issued for the vehicle by this state, including a duplicate 
or replacement title. 
           
     (d)  Upon receipt of an application and payment of fees any county clerk shall, if satisfied that 
the applicant is the owner of the vehicle for which application for certificate of title is made, issue a 
paper certificate of title or electronic certificate of title, if available, upon a form or electronic 
format, approved by and provided at cost to the county clerk by the department in the name of the owner 
bearing the signature and seal of the county clerk's office. The county clerk shall not deliver a 
certificate of title issued under this section until presentation of a receipt for payment of sales or use 
tax pursuant to W.S. 39-15-107(b) or 39-16-107(b).       
                                                                
                                       Wyoming Salvage Statute Information 
  W.S. 31-2-107.  Titles for damaged vehicles; return of certificate of title and registration for 
damaged vehicle; replacement title and registration. 
   
    (a)  When a motor vehicle is declared a total loss by the insurance company or, in the event an 
insurance company is not involved in the settlement of the claim, sustains damage in an amount exceeding 
seventy-five percent (75%) of its actual retail cash value, as set forth in any current edition of a 
nationally recognized automotive appraisal guide or other source approved by the Wyoming insurance 
department, the owner or insurance company, if it obtains ownership of the vehicle through transfer of 
title as a result of a settlement of an insurance claim, shall forward the properly endorsed certificate 
of title to the office of the county clerk that issued the certificate of title together with an 
application for a certificate of title branded salvage and payment of the fee required under W.S. 
31-3-102(a)(vii) to obtain a properly branded certificate of title. When any vehicle accident report is 
required under chapter 5, article 11 of this title, the investigating officer shall provide written notice 
to the owner or operator of the vehicle of the requirements under this section. 
     
     (d)  This section shall not apply to motor vehicles with more than eight (8) years of service except 
any vehicle that was previously issued a title from any state that bore any word or symbol signifying that 
the vehicle was "salvage", "unrebuildable", "parts only", "scrap", "junk", "nonrepairable", 
"reconstructed", "rebuilt" or any other symbol or word of like kind, or that it has been damaged by flood, 
shall obtain a Wyoming title with the prior brand or any other information concerning the motor vehicle 
status, carried forward on any subsequent Wyoming title regardless of years of service.