Mechanice Lien over $4000

Mechanic Lien Sale Request Form for VEHICLE VALUED OVER $4000

The cost to process a lien sale is $75.00. Please fill out the form below. Information with the red star is mandatory.

License Number *

State Registered *

License Exp Date *

VIN *

Date the vehicle came into my possession *

Date the owner billed for services *

Date work or services completed *

Total Repair Cost *

Lien sale date (must be over 45 days from today) *

Lien sale time *

Lien sale location address *

City *

State *

Zip Code *

Company Name *

Phone Number *

Address *

City *

State *

Zip Code *

Your Name *

Email *

Phone Number *

Credit Card Holder's Name *

Credit Card Number *

Expiration Date *

Security Code *

Billing Address *

City *

State *

Zip Code *

By hitting submit, I authorize ELT Data LLC to charge my credit card for $75.00.

Submit