T HIRD PARTY REQUEST FOR TITLE OR REGISTRATION CORRECTION
Wisconsin Department of Transportation (WisDOT)
MV1047 5/2015 S. 341.21 Wis. Stats.
Vehicle Identification Number (VIN) (standard VIN has 17 characters) | License Plate Number | Title Number |
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Terminal ID/ Dealer Number
| Agent’s Legal Business Name | | Contact Person |

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Describe in detail the change you are requesting
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And/Or Conjunction (Send current title and all customer signatures)
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Owner (Changes of ownership may require a completed MV1, MV11 or MV12, the original title and titling fees)
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Lien (Send current title, lien release, loan filing fee) (Owner and lender cannot be the same)
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Plates/Registration
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Other (mileage, color, lessee, etc.) Please provide explanation.
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NOTE: For Odometer corrections this form must be submitted along with the secured MV11 or MV2488 forms.
Please contact the Agent Partnership Unit with questions.
I agree to protect and indemnify the Wisconsin Department of Transportation in any claims arising out
of the issuance of a changed title or registration on the above-described vehicle. I also certify with my signature that to the best of my knowledge the information and statements on this request for changes are true and correct.
X
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(Signature)
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(Date – m/d/yyyy)
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Please send completed form to:
Wisconsin Department of Transportation
Agent Partnership Unit
PO Box 7909
Madison, WI 53707-7909
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