Self-Storage Lien -- Vehicle / Vessel Lien Sale

Jomick Lien Sales
www.jomickliensales.com
jomickliensales@gmail.com
(209) 408-5831

Self-Storage Lien

VEHICLE / VESSEL LIEN SALE
Please make sure the information you enter below is true and correct. You must be owed money for storage, towing, or repairs to be eligible for a DMV Lien Sale. If you have purchased a vehicle and are trying to obtain a title, you cannot file a Lien.

Business Name*

If you are filing as a sole proprietor please use your name here and below. This will appear on documents.

Full Name (you must be at least 18 years old and authorized to file liens on behalf of the business listed above)*

First NameLast Name

Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Phone Number*

Format: (000) 000-0000.

Business E-Mail Address*

example@example.com

Storage Rate Per Day (in U.S. Dollars)*

Enter your posted daily storage rate here and we will calculate your storage fees for you.

YESNO, I have a different mailing address

YES - The Storage Address is the Same as the Business AddressNO - The vehicle is stored at a different address

Mailing Address - ONLY if different from business address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Storage Address of Vehicle / Vessel - ONLY if different from business address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

LIEN SALE INFORMATION

DATE OF DEFAULT (What date was the Vehicle/Vessel storage payment considered past due?)*

NAME AND ADDRESS OF WHO AUTHORIZED THE LIEN
Please provide the Name and Address of the person who authorized towing, storage, or repairs. (If towing was authorized by law enforcement please specify which agency)

Date you last billed or invoiced this person

Last Billed Date

Name of Person or Agency that authorized Storage*

First Name (if Agency, put City for the First Name - e.g. Oakland)Last Name (if Agency put Dept. for the Last Name - e.g. PD, CHP)

Address of Person or Agency that authorized Storage*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

ANY ADDITIONAL INTERESTED PARTIES - Please list all full names and addresses of any known entity that may have an interest in this Vehicle/Vessel - such as: insurance company, alternative contact, etc. (LEAVE BLANK IF NONE)

VEHICLE / VESSEL INFORMATION

Car, Truck, RV, Bus, Motorhome, Carrier, Van, etc.Motorcycle or ATV / OHVBoat (No Trailer)Boat and Trailer

About the Vehicle

Vehicle Year of Manufacture*

e.g., 1999, 2021, etc. ( if unknown type UNKNOWN )

Vehicle Make (Manufacturer)*

e.g., Ford, Honda, Harley Davidson, etc. ( if unknown type UNKNOWN )

Vehicle Model*

e.g., Camry, Accord, Focus, Model S, etc. ( if unknown type UNKNOWN )

Vehicle Identification Number (VIN #)*

The VIN can be found on the vehicle (this includes motorcycles).

License Plate Number and State*

e.g., 1234RG CA ( if none, type NA )

Motorcycle Engine Number*

This number should be stamped on the engine block. No lien sale can be done on motorcycles that do not have an Engine Number (or if an engine change has been done).

About the Boat
All watercraft licensed by the California DMV

Boat Year of Manufacture*

e.g., 1999, 2021, etc. ( if unknown type UNKNOWN )

Boat Make (Manufacturer) AND Model Name*

Boat Make and Model

Boat Length (in feet)*

e.g., 22 FT

Boat Hull Identification Number (HIN)*

Boat Hull ID Number

Boat CF Number*

Boat CF Number ( if none, type NONE )

About the Trailer
Trailer that goes with the Boat

Trailer Year of Manufacture*

e.g., 1999, 2021, etc. ( if unknown type UNKNOWN )

Trailer Make (Manufacturer)*

e.g., EZLOADER, etc. ( if unknown, type UNKNOWN)

Trailer VIN (Vehicle Identification Number)*

Could be stamped on the frame or located on the federal certification label near the tongue.

Trailer License Plate Number and State*

e.g., 1234RG CA ( if none, type NA )

FINAL REVIEW AND SUBMISSION
Please review the above information for errors before submitting. Also note that:
JOMICK LIEN SALES DOES NOT, AND CANNOT, PROVIDE LEGAL ADVICE IN ANY WAY

By submitting this form you are authorizing JOMICK LIEN SALES to file lien sale documents with the California DMV on your behalf using the information you have provided. You agree that you are authorized to file liens on behalf of the business listed on this form and have a valid lien on the vehicle/vessel pursuant to California laws. Furthermore, you agree to defend, indemnify, and hold harmless JOMICK LIEN SALES and all its associated agents from any lawsuits, judgements, and errors/omissions of any kind, under any circumstances.*

I understand and agree

Signature (type your FULL NAME)*

type your First Name and Last Name

Today's Date*

Today's Date