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Blank 5017 Missouri Template

The 5017 Missouri form is specifically designed by the Missouri Department of Revenue to facilitate the online filing of Notices of Lien and access to motor vehicle and marine records, with the added convenience of direct debit for payment processing. Individuals and businesses need to provide detailed information about their business, contact person, and account information to utilize this service. For seamless processing and to ensure compliance, completing sections A, B, C, and D accurately is crucial, following the provided instructions closely. Click the button below to start filling out your 5017 Missouri form today.

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Navigating the financial and administrative responsibilities of vehicle ownership in Missouri is streamlined with the use of the 5017 Missouri form. Crafted by the Missouri Department of Revenue Motor Vehicle Bureau, this essential document serves as an application for creating an online account that facilitates the electronic filing of Notice of Liens and provides access to motor vehicle and marine records directly from your computer. Whether the aim is to establish a new account, amend current account details, or cancel an existing arrangement, this form accommodates such needs across transaction types. Additionally, it offers an option for direct debit, making payments for transactions hassle-free. The form requires detailed information from applicants, including business and contact person details, financial institution information, and a direct debit authorization complete with a voided check or deposit slip for verification purposes. With its comprehensive approach to managing vehicle-related financial transactions, the 5017 form proves to be a crucial tool for individuals, businesses, and financial institutions engaged in the Missouri vehicle market.

Preview - 5017 Missouri Form

MISSOURI DEPARTMENT OF REVENUE

MOTOR VEHICLE BUREAU

PO BOX 2167, JEFFERSON CITY MO 65105-2167

(573) 526-3669 http://dor.mo.gov/mvdl

APPLICATION FOR ONLINE ACCOUNT

(NOTICE OF LIEN FILING/RECORDS ACCESS/DIRECT DEBIT)

SECTION A - APPLICATION/TRANSACTION TYPE - CHECK APPROPRIATE BOXES

FORM

5017

(REV. 8-2012)

APPLICATION TYPE

 

 

NEW

CHANGE

CANCEL

TRANSACTION TYPE(S) REQUESTED

 

ONLINE NOTICE OF LIEN FILING

ONLINE RECORD ACCESS

SECTION B - BUSINESS AND CONTACT PERSON INFORMATION - PLEASE TYPE OR PRINT USING A BALL POINT PEN.

SEE INSTRUCTIONS ON REVERSE SIDE.

 

 

BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT PERSON

 

 

 

 

 

NAME OF BUSINESS OR INDIVIDUAL

 

 

 

 

 

 

 

 

CONTACT PERSON’S NAME (LAST, FIRST, MIDDLE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT PERSON’S ADDRESS (STREET, RR, OR PO BOX NUMBER)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE INSTRUCTIONS ON BACK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BUSINESS OR INDIVIDUAL’S ADDRESS (STREET, RR, OR PO BOX NUMBER)

CITY

 

 

 

 

 

 

 

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

STATE

 

 

ZIP CODE

E-MAIL ADDRESS

 

 

 

 

 

 

TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECURITY ACCESS CODE (DPPA NUMBER) - COMPLETE IF APPLYING FOR ONLINE RECORD

TYPE OF BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCESS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BANK

TITLE LOAN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INDIVIDUAL

SAVINGS AND LOAN

 

 

CREDIT UNION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEALER FILING AS LIENHOLDER

 

DEALER FILING FOR A LIENHOLDER

 

 

 

 

 

 

 

 

 

DEPARTMENT USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOWER (NO CHARGE FOR ONLINE RECORD ACCESS - DO NOT COMPLETE SECTION C OR SECTION D)

 

 

 

 

 

 

 

 

 

OTHER ___________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C - ACCOUNT INFORMATION - COMPLETE ONLY IF NEW APPLICATION OR CHANGING ACCOUNT INFORMATION.

FINANCIAL INSTITUTION NAME

TELEPHONE NUMBER

( )

FINANCIAL INSTITUTION ADDRESS (STREET, RR, OR PO BOX NUMBER)

CITY

STATE

ZIP CODE

ACCOUNT TYPE - CHECK ONLY ONE BOX

 

CHECKING

SAVINGS

GENERAL LEDGER

ROUTING NUMBER

DEPOSITOR (BUSINESS) ACCOUNT NUMBER

SECTION D - DIRECT DEBIT AUTHORIZATION - CHECK APPROPRIATE BOX.

A VOIDED CHECK OR DEPOSIT SLIP MUST BE ATTACHED.

I hereby authorize the Missouri Department of Revenue (Department) to initiate an electronic debit from the account identified above for payment of Notices of Liens processed and/or any records accessed online. I recognize that it is my responsibility to have the funds available in the account identified above for the withdrawal of my payment. I also understand that if the Department cannot deduct the payment from my account because funds are unavailable, I will be subject to overdraft fees from my financial institution. I will also be charged a dishonored payment penalty by the department. I further certify under penalties of perjury that I am authorized to sign this application and that any personal information obtained from any department records accessed will only be used as provided for in the federal Driver’s Privacy Protection Act.

I hereby cancel the authorization to electronically debit the account identified above.

SIGNATURE OF BUSINESS OWNER, PARTNER, CORPORATE OFFICER, OR INDIVIDUAL

PRINTED NAME OF BUSINESS OWNER, PARTNER, CORPORATE OFFICER, OR INDIVIDUAL TITLE OF BUSINESS OWNER, PARTNER, CORPORATE OFFICER, OR INDIVIDUAL

STAPLE VOIDED CHECK OR DEPOSIT SLIP HERE

DOR-5017 (8-2012)

PLEASE READ THIS INFORMATION CAREFULLY

COMPLETION INSTRUCTIONS

1.To apply for an online account to file Notices of Lien and/or access motor vehicle and marine records and have the payment for such transactions direct debited, complete this form as follows:

General Instructions

Complete Sections A, B, C, and D if you are enrolling for the first time, re-enrolling after cancellation, changing your existing debit authorization, or other information. If you are a tower, do not complete Sections C and D when requesting online record access only.

If you are cancelling your debit authorization, complete Sections A, B, and D only.

Section A - Application/Transaction Type

Application Type - Check the appropriate box.

1.New - Complete for new enrollment or re-enrollment after cancellation.

2.Change - Complete to change type of account, financial institution or branch routing number, depositor (business) account number, or other information.

3.Cancel - Complete to cancel your debit authorization.

Transaction Type(s) Requested - Check the appropriate box(es).

Section B - Business and Contact Person Information

Complete all blocks for both the business or individual and contact person information.

Security Access Code - This code is issued by the Motor Vehicle Bureau to entities who qualify under the Driver’s Privacy Protection Act to receive personal information contained in the department’s vehicle and marine records. If you indicate you would like online record access in Section A - Transaction Type(s) Requested, you must enter the Security Access Code. If you do not have a Security Access Code, you may apply by completing a Request for MV/DL Record(s)/Security Access Code (DOR-4678). The application can be obtained from any local contract office.

Identification Number - Please record the FDIC number (bank), NCUA number (credit union), Dealer number (licensed motor vehicle/boat dealer), FEIN (any other type of business), or SSN (individual) as the identification number. The last six blocks are for Department of Revenue use only.

Type of Business - Check the appropriate box.

Section C - Account Information

Financial Institution Information - Record the financial institution’s name, telephone number, address, city, state, and zip code.

Account Type - Check the appropriate box.

Routing Number - Your financial institution’s routing number is printed on the bottom left-hand portion of your business or personal checks or deposit tickets (the first 9 digits). See examples 1 and 2 below.

Depositor (Business) Account Number - Your depositor account number is printed on the bottom of your business or personal

checks following the routing number. It may be the first series of digits after the routing number followed by the check number

(example 1), or it may be the series of digits which follow the check number (example 2). NOTE: Check number is not included in the depositor account number.

 

Example 1

 

 

 

Example 2

 

 

 

 

XYZ BUSINESS

 

CHECK NO. 4444

 

XYZ BUSINESS

 

CHECK NO.

 

 

HOMETOWN, USA

 

 

HOMETOWN, USA

 

 

 

 

PAY TO THE ORDER OF ___________________________________

 

PAY TO THE ORDER OF ___________________________________

 

 

121456789

8765432109812

4444

 

R121456789

4444

8765432109812

 

 

 

 

 

 

 

 

 

 

 

Routing No.

Dep. Acct. No.

Ck. No.

 

Routing No.

Ck. No.

Dep. Acct. No.

 

 

 

 

 

 

 

 

 

NOTE: Credit unions and savings and loan associations may differ from the above examples. Please verify your depositor account number and electronic routing number with your financial institution.

Section D - Direct Debit Authorization

Check appropriate box. Attach a voided business or personal check or deposit slip to the front right-hand side of this application. This is necessary to verify the depositor account number, routing number, and financial institution.

2.Submit the completed application to the following address:

MOTOR VEHICLE BUREAU

PO BOX 2167

JEFFERSON CITY MO 65105-2167

CHANGE FINANCIAL INSTITUTION OR DEPOSITOR ACCOUNT INFORMATION

Debits (withdrawals) will continue to be made from the designated account at your financial institution until the Missouri Department of Revenue is notified that you wish to redesignate your account and/or financial institution. To redesignate, complete and submit a new Application for Online Account (Notice of Lien Filing/Records Access/Direct Debit) with the new information.

DOR-5017 (8-2012)

File Properties

Fact Description
Form Name and Number Missouri Form 5017 (Rev. 8-2012)
Purpose Application for online account for Notice of Lien Filing/Records Access/Direct Debit
Governing Body Missouri Department of Revenue, Motor Vehicle Bureau
Application Requirements Choose application type (New, Change, Cancel), transaction types requested, and provide business and contact person information. Account information and direct debit authorization are required for new and changing accounts.
Governing Law Adheres to the federal Driver’s Privacy Protection Act (DPPA) for personal information security.

How to Fill Out 5017 Missouri

Filling out a 5017 Missouri form is a straightforward process when one has a comprehensive guide at hand. This document pertains to the registration for an online account that assists with filing notices of lien and accessing motor vehicle and marine records with the option for payments to be auto-debited. Below, find the step-by-step instructions for completing the form correctly.

  1. Start with Section A by selecting the application type. You have three options: "New" for first-time applications, "Change" for updates to an existing account, or "Cancel" if you wish to terminate your online access or direct debit arrangements.
  2. In the same section, choose the transaction type(s) you are requesting. Your options include "Online Notice of Lien Filing" and/or "Online Record Access".
  3. Move on to Section B, which requires detailed business and contact person information. Use a ballpoint pen to fill in the name of the business or individual, the contact person’s name, identification number, and address information clearly and accurately. Do not forget to include the city, state, zip code, email address, and telephone number.
  4. If you are requesting online record access in Section A, enter the Security Access Code. If you do not have one, instructions to obtain it are provided, including completing an additional form (DOR-4678).
  5. Select the type of business or individual in the designated box. Options include bank, title loan, individual, etc.
  6. Proceed to Section C only if you are applying for a new account or making changes to an existing account’s financial information. Fill in your financial institution’s name, telephone number, address, city, state, zip code, and check the appropriate account type (checking, savings, or general ledger).
  7. Enter the financial institution’s routing number and your depositor (business) account number as they appear on your check or deposit slip. Make sure not to include the check number as part of the depositor account number.
  8. In Section D, indicate whether you are authorizing or canceling direct debit by checking the appropriate box. Attach a voided check or deposit slip to the right-hand side of this application for verification purposes.
  9. Ensure the business owner, partner, corporate officer, or individual signs and prints their name at the bottom along with their title.
  10. Finally, review the completed application for accuracy and completeness. Once finalized, mail it to the provided address: MOTOR Vehicle Bureau, PO Box 2167, Jefferson City MO 65105-2167.

After submitting the form, all debits (withdrawals) will continue from the designated account at your financial institution until the Missouri Department of Revenue receives notification from you to change or cancel this arrangement. Should there be any change in your financial institution or account information in the future, completing and submitting a new Application for Online Account with updated details will be necessary.

Understanding 5017 Missouri

What is the Missouri Form 5017 used for?

Missouri Form 5017 is an application used by individuals or businesses to enroll for an online account with the Missouri Department of Revenue Motor Vehicle Bureau. This account allows for the online filing of notices of lien, access to motor vehicle and marine records, and supports direct debit payments for these transactions. This form simplifies the process of managing financial transactions related to motor vehicles and marine vessels, ensuring compliance and prompt record-keeping.

Who needs to complete the Missouri Form 5017?

This form must be completed by any business or individual that needs to file notices of lien electronically or requires online access to motor vehicle and marine records for verifying ownership or lien status. It is particularly useful for banks, title loan companies, credit unions, dealers acting as lienholders, and savings and loan associations needing regular access to these records.

What are the primary sections of the Missouri Form 5017?

Missouri Form 5017 is structured into several sections, including:

  1. Section A - Application/Transaction Type: This section identifies whether the application is new, a change to an existing account, or a cancellation of direct debit authorization.
  2. Section B - Business and Contact Person Information: Applicants provide details about the business or individual, including contact information and a security access code for online record access, if applicable.
  3. Section C - Account Information: Specifies financial institution details for direct debit setups. This is only required for new applications or when changing account information.
  4. Section D - Direct Debit Authorization: This section includes the authorization for the department to initiate electronic debits for payment associated with the services requested.

How does one obtain a security access code for online record access?

To obtain a security access code necessary for online record access, one must apply by completing a Request for MV/DL Record(s)/Security Access Code (Form DOR-4678), available from any local contract office. This code is essential for those qualifying under the Driver’s Privacy Protection Act to access personal information contained in the department’s vehicle and marine records.

What is required for the direct debit authorization on the Missouri Form 5017?

For the direct debit authorization, the applicant must attach a voided check or deposit slip to the form. This attachment is crucial as it verifies the depositor account number, routing number, and financial institution details. The applicant must also authorize the department to initiate electronic debits for notices of lien processed and records accessed, ensuring sufficient funds are available for these transactions.

What steps should be taken if changing financial institution or account information?

If an applicant needs to update the financial institution or account information after the initial enrollment, a new Missouri Form 5017 must be completed with the new details and submitted to the Missouri Department of Revenue. It is important to note that debits will continue from the previously designated account until the department processes the new form with updated information.

Common mistakes

  1. One common mistake is not checking the appropriate application type box in Section A. Applicants sometimes overlook indicating whether the form is for a new application, a change to existing information, or a cancellation. This decision is crucial for processing the application correctly.

  2. Another frequent error occurs in Section B, where both the business and contact person information must be filled out. Applicants often fill in only one part, forgetting that details for both the business or individual and the contact person are mandatory. This includes providing complete addresses, identification numbers, and contact information.

  3. Incorrectly filling out the financial institution information in Section C can also lead to errors in processing the application. Specifically, applicants sometimes enter the wrong routing number or depositor account number for their bank. The routing number is usually the first nine digits at the bottom left of checks or deposit slips, but confusion arises when applicants misidentify these numbers or read them off improperly.

  4. Lastly, failing to attach a voided check or deposit slip in Section D is a common mistake. This step is crucial for the direct debit authorization process, as it verifies the bank account information. Applicants often overlook this requirement, which results in incomplete applications.

When filling out the Form 5017 for the Missouri Department of Revenue, it's important to read all instructions carefully and review each section to ensure all necessary information is provided accurately. Avoiding these common mistakes helps speed up the processing of the application, ensuring timely access to the services requested.

Documents used along the form

When dealing with the complex task of managing vehicle and marine liens in Missouri, utilizing Form 5017 is a critical step. However, this form is often just one component of a comprehensive paperwork process. Various other forms and documents typically accompany Form 5017 to ensure a seamless transaction and to comply with the regulations set forth by the Missouri Department of Revenue Motorcycle Bureau. Here’s a rundown of seven such documents often required alongside Form 5017 for a complete, thorough record-keeping and submission process.

  • Request for MV/DL Record(s)/Security Access Code (DOR-4678): Essential for businesses or individuals needing a security access code to request online records access. This form helps in obtaining the authorization needed to access sensitive driver and vehicle information.
  • Title Application (DOR-108): Used to apply for a vehicle title in Missouri. It is critical for lienholders to ensure that titles reflect the correct ownership and lien information.
  • Notice of Lien, Lien Release, or Authorization to Add/Remove Name from Title (DOR-4809): This document is necessary when updating lien information on a vehicle’s title – whether adding a new lien, releasing an existing one, or authorizing changes in the vehicle title concerning lienholders.
  • Odometer Disclosure Statement (DOR-3019): Required during the sale of a vehicle, this form ensures that accurate mileage is reported and acknowledged by both seller and buyer, potentially affecting lien values.
  • General Affidavit (DOR-768): A versatile form used for various declarations, corrections, or updates that might accompany a lien transaction, such as address changes or corrections to vehicle details.
  • Personal Property Tax Receipt: Shows that personal property taxes have been paid. It's a necessary document to demonstrate tax compliance when processing lien-related paperwork.
  • Voided Check or Deposit Slip: While directly referenced in the 5017 form for setting up direct debit, a voided check or deposit slip is often submitted along with the paperwork to facilitate financial transactions related to the lien filing.

Each of these documents plays its part in the intricate dance of lien management, ensuring that all legal and regulatory bases are covered. From initiating lien filings to adjusting title records and ensuring financial transactions are processed seamlessly, these documents work in concert with Form 5017 to maintain the integrity and accuracy of Missouri’s motor vehicle and marine records. Understanding and preparing these documents in advance simplifies the process, ensuring compliance and peace of mind for all parties involved.

Similar forms

The 5017 Missouri form is similar to several other types of documents that facilitate similar transactions or authorizations between individuals, businesses, and government or financial institutions. Each of these documents plays a vital role in ensuring that transactions or activities are conducted in a legally binding manner, providing a layer of security and formality to various operations.

Uniform Commercial Code (UCC) Financing Statement (Form UCC1): This document is quite similar to the 5017 Missouri form in the way it registers a security interest. Both are used to publicize a lien against assets used as collateral for loans. The UCC Financing Statement is broadly used across the United States to declare a lien on personal property, whereas the 5017 Missouri form is specific to motor vehicles in Missouri. They share the fundamental purpose of protecting lenders by notifying interested parties of the lien, thus ensuring the lienholders’ rights are preserved. The main differences lie in their scope (UCC1 is more general and not limited to motor vehicles) and geographic applicability (UCC1 can be filed in any state, while Form 5017 is Missouri-specific).

Electronic Lien and Title (ELT) Program Enrollment: Like the 5017 Missouri form, ELT programs in various states allow lienholders to electronically manage titles and liens. Both eliminate the need for paper titles by facilitating the electronic transmission of lien notifications and title information between lienholders and the state's Department of Motor Vehicles (DMV) or equivalent. This electronic approach simplifies the process of lien management and reduces the risk of fraud or loss associated with paper titles. While the 5017 Missouri form is an application that includes an option for online account setup for lien notifications, ELT enrollment forms specifically enroll a lienholder in electronic processing with the state, making title and lien transactions more efficient.

Direct Debit Authorization Forms for Automated Payments: The part of the 5017 Missouri form that pertains to direct debit authorization shares similarities with generic direct debit authorization forms used by financial institutions and other agencies for setting up automatic payments. Both types of documents authorize an entity to electronically debit an individual's or organization's account for payments due. This component is critical for the smooth processing of recurring transactions, such as lien payments or record access fees in the case of the 5017 form, ensuring timely and consistent payment without the need for manual processing. While the 5017 form applies specifically to transactions with the Missouri Department of Revenue, generic direct debit forms are widely used for various types of automatic bill payments.

Dos and Don'ts

When completing the Form 5017 for the Missouri Department of Revenue, it’s important to follow these guidelines to ensure your application is processed smoothly. Paying attention to these do's and don'ts will help avoid common mistakes.

  • Do verify the application type in Section A and check the appropriate box for new, change, or cancel.
  • Do provide complete and accurate information for both the business and contact person in Section B.
  • Do ensure that the Security Access Code (DPPA Number) is entered if applying for online record access.
  • Do confirm the financial institution’s information, including routing and depositor account numbers, in Section C for accuracy.
  • Do attach a voided check or deposit slip when authorizing direct debit in Section D.
  • Don’t skip any required fields, as incomplete applications may result in processing delays.
  • Don’t guess your routing or account numbers; verify them with your financial institution to prevent errors.
  • Don’t use a pencil or non-permanent writing tool; fill out the form using a ballpoint pen or print it electronically for clarity.

Accuracy is crucial when filling out legal documents. Double-check your entries before submitting the form to the Missouri Department of Revenue. Following these guidelines will save time and ensure that your transactions are processed without unnecessary setbacks.

Misconceptions

  • One common misconception is that the Form 5017 is only used by businesses. While it's true that businesses make use of this form, it is also available to individuals, especially those acting as private lienholders or needing access to certain vehicle records.

  • Some believe that completing the Form 5017 automatically grants them unlimited access to motor vehicle and marine records. Access is actually limited and strictly regulated, with specific transaction types that need to be checked and appropriate security clearance (DPPA number) obtained.

  • It's often misunderstood that once you're set up for direct debit with the Form 5017, changing your bank account information is complicated. In reality, updating your financial institution information or account type simply requires submitting a new form with the updated details.

  • Many think that if they are not a bank, credit union, or auto dealer, they cannot file for a lien electronically through the Form 5017. However, a range of business types, including title loan companies and savings and loan institutions, can apply, as indicated in the "Type of Business" section.

  • There's a misconception that the section for direct debit authorization doesn't need to be filled if you're not changing your account information. This section must be completed for new applications to ensure the Department of Revenue can process liens and access fees electronically from the right account.

  • Some believe that attaching a voided check or deposit slip is optional. In fact, this is a mandatory step to verify your financial institution details and ensure the correct setup for direct debits.

  • Another misunderstanding is about the security access code (DPPA number). It's thought that this is optional for every applicant. This code is critical for applicants who wish to access online records and must be obtained and provided in the application when relevant.

  • It's incorrectly assumed that all sections of the Form 5017 must be completed by everyone. The form instructions specify that towers (those providing towing services) do not need to complete the account information and direct debit authorization sections if they are only requesting online record access.

  • Finally, there's the misconception that there are charges for online record access. This service is provided free of charge by the Missouri Department of Revenue, as noted in the instructions, which encourage not filling out the payment sections if accessing records online is the sole purpose.

Key takeaways

When dealing with the Missouri Department of Revenue's Form 5017 for online account applications, noting the specifics can streamline the process and ensure compliance. Here are key takeaways for effectively filling out and using this form:

  • The purpose of Form 5017 revolves around setting up an online account for Notices of Lien Filing, Records Access, and Direct Debit transactions.
  • Section A of the form requires the applicant to specify the type of application—whether it's new, a change in details, or a cancellation—and the type of transaction needed.
  • In Section B, detailed information about the business or individual, alongside contact person details, must be provided. This includes names, identification numbers, addresses, and contact information.
  • A Security Access Code is necessary for online record access. Applicants who do not currently possess this code need to apply separately through a Request for MV/DL Record(s)/Security accelerating Code (DOR-4678).
  • The form asks for the Type of Business using a list of predefined categories such as banks, title loans, individuals, and dealers, among others.
  • Financial information is crucial in Section C, where applicants outline their financial institution's details, account type, and routing and account numbers. This section is mandatory for new applications or when changing account information.
  • Direct Debit Authorization in Section D is a critical component for processing payments associated with lien notices or records accessed online. This section requires a voided check or deposit slip attachment for verification purposes.
  • Applicants bear responsibility for ensuring sufficient funds are available in their accounts for debit transactions, with explicit acknowledgment that failure may result in overdraft fees and penalties.
  • Form 5017 includes a certification under penalty of perjury that the applicant is authorized to submit the application and will use any accessed information according to the federal Driver’s Privacy Protection Act.
  • Completion and submission of the form require attention to the enclosed instructions, ensuring all appropriate sections are filled out based on the applicant's specific needs and changes.

Attention to detail when completing the 5017 form not only facilitates smoother transactions with the Missouri Department of Revenue but also aligns with legal and procedural obligations, ensuring that all transactions are processed efficiently and securely.

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