Dealer Application for Certificate of Mobile Home Ownership

  • MM slash DD slash YYYY
  • (Include Area Code)
  • This information about the mobile home sold is for statistical purposes only:

  • (Including federal tax, freight and accessories)
  • (service fee, etc.)
  • 1. DO NOT sign a blank form.
    2. If your Certificate of Mobile Home ownership is NOT received within 60 days, contact a Secretary of State Office.
    3. The Dealer must provide the purchaser a copy of this application after the sales tax and Certificate of Mobile Home Ownership fees have been paid.

    I certify I sold this manufactured home to the purchaser listed on this form and I further certify at time of delivery the mobile homes is subject to the security interest named.
  • I (we), the purchaser(s) of this mobile home, certify it is equipped with 1 fire extinguisher and smoke detector as required by 1974 PA 133, MCL125.711 et seq. of the Michigan Complied Laws.
  • Failure to file for a Certificate of Mobile Home Ownership within 30 days of the sale will result in a late fee of $15.00

    Authority Granted under 1987 PA 96 to receive a Certificate of Mobile Home Ownership.

    LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities.

    BCC-944 (rev. 9/14)
  • This field is for validation purposes and should be left unchanged.