Notice to Surrender Motor Vehicle and Vessel

The following is the notice that delivered to the registered owner to request the immediate surrender and delivery of a motor vehicle to the lienholder. The mentioned form has to be completed and submitted to the Division of Motorist Services of the Department of Highway Safety and Motor Vehicles in the State of Florida.

Extracted Text for Proper Search

STATE OF FLORIDA  
DEPARTMENT  OF  HIGHWAY  SAFETY AND  MOTOR  VEHICLES  	
Division of  Motorist  Services  	
NOTICE TO SURRENDER MOTOR VEHICLE/VESSEL 	
DATE:  _____________________ 
Registered Owner’s Name(s): 
Address: City:
State: Zip:
Lienholder’s Name: 
Lienholder’s Address:  City: 
State: Zip:  Lienholder’s Telephone Number: 
You are  hereby  given  notice  to  IMMEDIATELY  surrender  and deliver  the  motor  vehicle  or  vessel  (described  
below) to  the  lienholder	:  	
Year:  Make:  Vehicle/Hull Identification Number: 
Model: Body Style:  Color: Registration License Plate Number: 
The motor  vehicle  or  vessel  shall be  surrendered  during  regular  business  hours  of:     ___________________________,  
between                                                                                                                                                                  (Days of the Week) 
the  hours  of  _______ __	

__________________  to  the  following  location: 	
        (Business  Hours)  	
Surrender Address for Vehicle or Vessel:  City: 
State: Zip:  Lienholder’s Telephone Number: 
Failure to  surrender  the motor  vehicle  or  vessel  as required  by  section  320.1316,  Florida  Statutes,  will  result 
in  your  name  being placed  on  a  list  maintained  by  the  Department  of  Highway  Safety  and  Motor  Vehicles,  
which  will  prevent  you from  being  issued  a  license  plate revalidation  sticker,  or  replacement  license  plate 
for  any  motor  vehicle  or  vessel  under Florida  Statute  320.02(17),  owned  by  you  at  the  time  this notice  was  
given.   If the  motor  vehicle  or  vessel  is owned  jointly by  more  than  one  person,  the  name  of each  registered 
owner  shall be placed  on  the  list.   The  stop  will  remain  on  all  motor  veh	

icles/vesse	
 ls you  own  until  you  have  
either  returned  the  motor  vehicle/vessel  or until  you pay  the full  balance  owed.  	
Authorized Signature of the Lienholder: 	
This form  must  be  accurately  completed  and  signed  by  the  lienholder  prior  to  being  sent  to  the  
owner.   The lienholder  should  maintain  a  copy  of  the  completed  form  for  its  records.   When 
applying  to add  a  repossession  recovery  attempt  stop,  an additional  copy  of  the  completed  form  
must  be  submitted  to  the  department  with an  accurately  completed  and  signed  form  HSMV  82191 .  HSMV 82192 (06/14) S 	
   www.flhsmv.gov