STATE OF INDIANA SS: COUNTY OF BOONE IN THE BOONE SUPERIOR COURT CAUSE NO. 06C01-1604-MI-0238 IN THE MATTER OF AN APPLICATION FOR AN ORDER TO BMV TO ISSUE A REPLACEMENT CERTIFICATE OF TITLE Tammie Pluchel, Petitioner Petitioner: 317-758-5032 VERIFIED PETITION FOR AN ORDER TO THE INDIANA BUREAU OF MOTOR VEHICLES TO ISSUE A REPLACEMENT CERTIFICATE OF TITLE I hereby state under oath that the following statements are true: 1. I am at least eighteen (18) years of age, and I am competent to make this Verified Petition for an Order to the Indiana Bureau of Motor Vehicles to Issue a Replacement Certificate of Title. 2. I am requesting the Court to order the Indiana Bureau of Motor Vehicles to issue a replacement certificate of title. 3. I am the owner of a vehicle described and identified as follows: Year: 2006 Make: Fleetwood Model: Unkown VIN: WCR1013 4. I became owner of the vehicle on or about September, 2013. I have attached a copy of the receipt or bill of sale. 5. The original certificate of title had been destroyed, lost or is otherwise unobtainable, and no duplicate certificate of title exists. The original certificate of title was destroyed, lost or is otherwise unobtainable under the following specific circumstances: Original title lost by owner-home sold to Elm Street MHP without title. 6. I have attached the affidavit of police inspection of the vehicle. 7. I am entitled to receive a replacement certificate of title. 8. The following information about me is true and accurate: Name: Tammie Pluchel DOB: 07/28/36 Address: P.O. Box 1034, Westfield, IN 46074 9. The following entity has a legal or equitable interest in the vehicle and should be designated as a lienholder upon the replacement certificate of title because the vehicle is security for an existing loan or obligation: N/A 10. I understand fully all statements and representatives in this Petition. 11. I respectfully request the Court to enter an order waiving collection of a filing fee or court costs that otherwise may be due as a result of this application because collection of such a fee or costs would be contrary to the interests of justice. I AFFIRM UNDER THE PENALTIES FOR PERJURY, A CRIMINAL OFFENSE PUNISHABLE BY IMPRISONMENT AND THE PAYMENT OF FINE AND COSTS, THAT THE FOREGOING FACTS AND STATEMENTS ARE TRUE AND ACCURATE. Date: 04/08/16 Tammie Pluchel This Petition is assigned for hearing on June 14, 2016 @ 8:00 A.M. TLR-237 5/17, 24 & 31 hspaxlp
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