The title issued by the Tax Commission shall be printed on safety paper and be in substantially the following form, on the face of the title:

OSAGE NATION

VEHICLE CERTIFICATE OF TITLE

Body Type	Model Year	Vehicle Identification Number	Title Number
__________	__________	__________	__________
Make	Date Issued	Factory Delivered Price
__________	__________	__________
Model	Date First Sold	Total Delivered Price	Gross Vehicle Weight Rating (if required)
__________	__________	__________	__________

Liens:

Date	Time	Name	Address	City	State	Zip
1st ___________________________________________________________________________________
2nd ___________________________________________________________________________________

*In cases where the vehicle is leased, the name and address of the Lessor and Lessee shall be listed.

Tag Number	Owner Name and Address	Initial Decal No.
__________	__________	__________
Previous Title Jurisdiction:
__________________________
Title Number
__________

I hereby certify that according to the records of the Osage Nation Tax Commission of the Osage Nation, the person named above is the owner of the vehicle described above. No certification is made that lien information contained hereon is accurate or correct.

By: __________

Osage Nation Tax Commission

[SEAL]

(Keep this certificate in a safe place. Do Not accept a certificate showing any erasure, alteration, or mutilation.)

And on the reverse side of said certificate:

IMPORTANT NOTICE

Every person who is not a licensed dealer in used cars is required to apply for a transfer title within twenty (20) days after acquiring ownership or possession of this vehicle. Failure to do so subjects the owner or possessor to a civil penalty.

Any assignment must be signed and sworn to before a notary public. The previous year’s Registration Certificate should accompany this title.

ASSIGNMENT OF TITLE

For value received, I/we hereby sell, assign, convey, and transfer unto:

Full Name: __________

Address: __________

City/State/Zip: __________

The vehicle described on the reverse side of this certificate, warrant the title to the same, and certify that at the time of delivery the vehicle is subject to the following liens or encumbrances and none other:

Date: __________ Amount(s): __________

In Favor of: __________

Address: __________

This vehicle (has)(has not) been involved in a casualty or loss.

The registration decal number for this vehicle is: __________.

Year ____. The current odometer reading is: __________.

__________

Signature of Seller

Subscribed and sworn to before me this ____ day of __________, 20 ____.

[SEAL]

__________

Notary Public

My Commission Expires: ____________________

For value received, I/we hereby sell, convey, and transfer unto:

Full Name: __________

Address: __________

City/State/Zip: __________

The vehicle described on the reverse side of this certificate, warrant the title to the same, and certify that at the time of delivery the vehicle is subject to the following liens or encumbrances and none other:

Date: __________ Amount(s): __________

In Favor of: __________

Address: __________

This vehicle (has)(has not) been involved in a casualty or loss.

The registration decal number for this vehicle is: __________.

Year ____. The current odometer reading is: __________.

__________

Signature of Licensed Used Car Dealer

Subscribed and sworn to before me this ____ day of __________, 20 ____.

[SEAL]

__________

Notary Public

My Commission Expires: _________________________