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.
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.
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
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
( )
FINANCIAL INSTITUTION ADDRESS (STREET, RR, OR PO BOX NUMBER)
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
CHECK NO.
HOMETOWN, USA
PAY TO THE ORDER OF ___________________________________
121456789
8765432109812
4444
R121456789
Routing No.
Dep. Acct. No.
Ck. 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:
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.
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.
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.
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.
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.
Missouri Form 5017 is structured into several sections, including:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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:
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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