Auto Lien Sales Submission Form

Lewis Lien Sales

An Auto Lien Sale Processing Service Company

Auto Lien Submission Form

LIEN INFORMATION

Use this form below to have one of our representatives contact you. We can start your lien today!
Click here to pay for your lien(s).

By submitting this form, I hereby certify under penalty of perjury under the laws of the State of California that the information entered by me on this document is true and correct and I have no information or belief that there is a valid defense to the claims which give rise to the lien(s). I have verified the below vehicle for correct valuation, license plate and vehicle identification numbers. Lewis Lien Sales will assume no responsibility for illegible or missing information. I appoint Lewis Lien Sales as Power of Attorney and authorize Lewis Lien Sales or its employees to sign on my behalf for the purpose of a lien sale on the below vehicle.

First Name:
Last Name:
Company Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Vehicle/Vessel Information:
VIN or Hull Number:
Is the Vehicle/Vessel in your possession?:
Date of Possession:
License Plate or CF Number:
State:
Make:
Model:
Year:
Motorcycle Engine Number:
Repair Shop Bar Number (Required if charging repairs.):
Repair Amount:
Daily Storage Charge:
Vehicle Value:	Under $4000
	Over $4000

Vessel Value:	Under $1500
	Over $1500


How did you hear about us?:

Please enter your full name for authorization of this lien sale submission. This will act as your signature.
Comments:	Enter comments here!

PLEASE NOTE: You may submit your lien information without paying in advance, however, unless we have had previous transactions with you, we will not begin processing the lien until payment has been received.

If you do not want to pay with PayPal, we will accept payment by telephone with your Mastercard or Visa credit card, or with check or money order payable to Lewis Lien Sales and mailed to the following address:

Lewis Lien Sales
1625-C Centinela Avenue
Inglewood, CA 90302

Upon payment we will begin processing your paperwork. You should receive your lien papers in 5-7 business days.