Form TR-12 "Application for an Original Michigan Salvage/Scrap Title" - Michigan

What Is Form TR-12?

This is a legal form that was released by the Michigan Department of State - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2021;
  • The latest edition provided by the Michigan Department of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form TR-12 by clicking the link below or browse more documents and templates provided by the Michigan Department of State.

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Download Form TR-12 "Application for an Original Michigan Salvage/Scrap Title" - Michigan

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SALVAGE TITLE
(Check One)
APPLICATION FOR AN ORIGINAL MICHIGAN
SCRAP TITLE
If flood damage and salvage or scrap status, check the "FLOOD DAMAGED" box
PLEASE PRINT IN INK OR TYPE
Clear Form
below. If flood damage does not dictate salvage or scrap status, use the TR-11L
(See Instructions On Reverse Side)
title application.
DAMAGE DESCRIPTION:
YEAR
MAKE
MODEL
BODY STYLE
FRONT
*
VEHICLE IDENTIFICATION NUMBER
FEE CAT OR WGT
COLOR (TOP/BOTTOM)
RIGHT FRONT
RIGHT SIDE
RIGHT REAR
REAR
LEFT SIDE
OWNER NAME(S)
LEFT REAR
CHECK IF TITLE TO READ
“FULL RIGHTS TO SURVIVOR”
LEFT FRONT
STE/UNIT #
STREET ADDRESS
BURNED
ROLL OVER
STRIPPED
CITY
STATE
ZIP CODE
FLOOD
MAJOR COMPONENT PARTS NOT SALVAGEABLE:
FIRST SECURED INTEREST
FILING DATE
A.
FRONT BUMPER
M.
LEFT REAR
DOOR
STREET ADDRESS
B.
HOOD
N.
LEFT FRONT
C.
ENGINE
DOOR
CITY
STATE
ZIP CODE
D.
TRANSMISSION
O.
LEFT FENDER
E.
RIGHT FENDER
P.
FRAME OR
*
CORRECTED TITLE
SUPPORTING
F.
RIGHT FRONT DOOR
STRUCTURE
WHICH SERVES
STATE REASON
G.
RIGHT REAR DOOR
AS A FRAME
VEHICLE PURCHASED FROM
PURCHASE DATE
H.
RIGHT REAR
Q.
PASSENGER
QUARTER PANEL
VEHICLE BODY
STREET ADDRESS
I.
REAR BUMPER
R.
TRUCK CAB
J.
DECK LID, TAIL GATE,
S.
PICKUP TRUCK
HATCHBACK
CARGO BOX
CITY
STATE
ZIP CODE
K.
TRUNK FLOOR PLAN
T.
VAN BACK
DOOR(S)
VEHICLE USE AND HISTORY DISCLOSURE:
L.
LEFT REAR
QUARTER PANEL
FLOOD DAMAGED
POLICE VEHICLE
GOVERNMENT VEHICLE
TAXI
*
USE TAX RETURN—USE THIS SECTION FOR TAX CALCULATION
ALL PARTS SALVAGEABLE
1. Full purchase price or retail value whichever is greater ..................................... $
BRANCH USE ONLY
LEGAL PAPERS
2. 6% (x.06) ............................................................................................................ $
TYPE OF DOCUMENT
COUNTY
3. Credit for tax paid to a reciprocal state (proof attached). .................................. $
STATE
COURT
4. Amount of tax being paid................................................................................... $
*
USE THIS SECTION IF CLAIMING TAX EXEMPTION
FILE OR DOCKET NUMBER
DATE EXAMINED
STATE REASON
BRANCH OFFICE
EXAMINER (Print)
Any false statement, alteration, forgery, or fraud in
TITLE FEE $
connection with this title transaction is a crime.
NAME:
I (we) certify I (we) own this vehicle and all information shown on this application is correct to
OWNER
the best of my (our) knowledge. I (we) further certify this vehicle qualifies for a salvage title or
scrap title according to the standards on the reverse side.
I.D. PRESENTED:
OWNER’S SIGNATURE
PRINTED NAME OF SIGNER
OTHER
X
ESTIMATED COST OF REPAIR ÷ BY PRE-DAMAGED VALUE x 100=PERCENT DAMAGED FIGURE
SEE REVERSE
IF YOUR TITLE IS NOT RECEIVED WITHIN 10
ESTIMATED COST OF REPAIR
PRE-DAMAGED FAIR MARKET VALUE PERCENT DAMAGED
SIDE FOR
DAYS FROM THE DATE OF FILING, CONTACT A
DAMAGE
SECRETARY OF STATE OFFICE.
$
$
% INFORMATION
A LICENSE PLATE CANNOT BE PURCHASED FOR OR DISPLAYED ON THIS VEHICLE
Authority granted under Public Act 300 of 1949 as amended.
*See instructions on back
Michigan Department of State
TR-12 (03/21)
SALVAGE TITLE
(Check One)
APPLICATION FOR AN ORIGINAL MICHIGAN
SCRAP TITLE
If flood damage and salvage or scrap status, check the "FLOOD DAMAGED" box
PLEASE PRINT IN INK OR TYPE
Clear Form
below. If flood damage does not dictate salvage or scrap status, use the TR-11L
(See Instructions On Reverse Side)
title application.
DAMAGE DESCRIPTION:
YEAR
MAKE
MODEL
BODY STYLE
FRONT
*
VEHICLE IDENTIFICATION NUMBER
FEE CAT OR WGT
COLOR (TOP/BOTTOM)
RIGHT FRONT
RIGHT SIDE
RIGHT REAR
REAR
LEFT SIDE
OWNER NAME(S)
LEFT REAR
CHECK IF TITLE TO READ
“FULL RIGHTS TO SURVIVOR”
LEFT FRONT
STE/UNIT #
STREET ADDRESS
BURNED
ROLL OVER
STRIPPED
CITY
STATE
ZIP CODE
FLOOD
MAJOR COMPONENT PARTS NOT SALVAGEABLE:
FIRST SECURED INTEREST
FILING DATE
A.
FRONT BUMPER
M.
LEFT REAR
DOOR
STREET ADDRESS
B.
HOOD
N.
LEFT FRONT
C.
ENGINE
DOOR
CITY
STATE
ZIP CODE
D.
TRANSMISSION
O.
LEFT FENDER
E.
RIGHT FENDER
P.
FRAME OR
*
CORRECTED TITLE
SUPPORTING
F.
RIGHT FRONT DOOR
STRUCTURE
WHICH SERVES
STATE REASON
G.
RIGHT REAR DOOR
AS A FRAME
VEHICLE PURCHASED FROM
PURCHASE DATE
H.
RIGHT REAR
Q.
PASSENGER
QUARTER PANEL
VEHICLE BODY
STREET ADDRESS
I.
REAR BUMPER
R.
TRUCK CAB
J.
DECK LID, TAIL GATE,
S.
PICKUP TRUCK
HATCHBACK
CARGO BOX
CITY
STATE
ZIP CODE
K.
TRUNK FLOOR PLAN
T.
VAN BACK
DOOR(S)
VEHICLE USE AND HISTORY DISCLOSURE:
L.
LEFT REAR
QUARTER PANEL
FLOOD DAMAGED
POLICE VEHICLE
GOVERNMENT VEHICLE
TAXI
*
USE TAX RETURN—USE THIS SECTION FOR TAX CALCULATION
ALL PARTS SALVAGEABLE
1. Full purchase price or retail value whichever is greater ..................................... $
BRANCH USE ONLY
LEGAL PAPERS
2. 6% (x.06) ............................................................................................................ $
TYPE OF DOCUMENT
COUNTY
3. Credit for tax paid to a reciprocal state (proof attached). .................................. $
STATE
COURT
4. Amount of tax being paid................................................................................... $
*
USE THIS SECTION IF CLAIMING TAX EXEMPTION
FILE OR DOCKET NUMBER
DATE EXAMINED
STATE REASON
BRANCH OFFICE
EXAMINER (Print)
Any false statement, alteration, forgery, or fraud in
TITLE FEE $
connection with this title transaction is a crime.
NAME:
I (we) certify I (we) own this vehicle and all information shown on this application is correct to
OWNER
the best of my (our) knowledge. I (we) further certify this vehicle qualifies for a salvage title or
scrap title according to the standards on the reverse side.
I.D. PRESENTED:
OWNER’S SIGNATURE
PRINTED NAME OF SIGNER
OTHER
X
ESTIMATED COST OF REPAIR ÷ BY PRE-DAMAGED VALUE x 100=PERCENT DAMAGED FIGURE
SEE REVERSE
IF YOUR TITLE IS NOT RECEIVED WITHIN 10
ESTIMATED COST OF REPAIR
PRE-DAMAGED FAIR MARKET VALUE PERCENT DAMAGED
SIDE FOR
DAYS FROM THE DATE OF FILING, CONTACT A
DAMAGE
SECRETARY OF STATE OFFICE.
$
$
% INFORMATION
A LICENSE PLATE CANNOT BE PURCHASED FOR OR DISPLAYED ON THIS VEHICLE
Authority granted under Public Act 300 of 1949 as amended.
*See instructions on back
Michigan Department of State
TR-12 (03/21)
SALVAGE TITLE
1. Vehicles whose estimated cost of repair is 75% or greater but less than 91% of the pre-damaged value must be titled with a salvage
(or scrap) title. Vehicles with damage less than 75% may voluntarily be titled as salvage.
2. List all major component parts that are not salvageable, or that all parts are salvageable.
3. Send proof of ownership, fees, and this application to Michigan Department of State.
4. Salvage title fee: $15. Tax is due unless otherwise exempt (see below). Dealers and insurance companies are exempt from tax when
holding vehicle for resale.
5. The certification on the other side of this application indicates the applicant has an estimate for repair on file which verifies the
estimated cost of repair and pre-damage value. The applicant should keep this information for five years in case it is requested or
needed again.
SCRAP TITLE
1. Vehicles whose estimated cost of repair is 91% or greater than the pre-damaged value must receive a scrap title. Vehicles with
damage less than 91% may voluntarily be titled as scrap.
2. List all major component parts that are not salvageable, or that all parts are salvageable.
3. Send proof of ownership, fees, and this application to Michigan Department of State, PO Box 30330, Lansing, MI 48909-7830.
4. Scrap title fee: $20. Tax is not due with scrap titles.
VEHICLE COLOR
1. The color code(s) must be selected from the list below.
2. If the vehicle is all one color,
enter the color
code in the first 3 spaces.
3. Top color/bottom color format is used for two tone vehicles.
4. Multicolor (MUL) cannot be used in combination with any other color.
COLOR
CODE
COLOR
CODE
COLOR
CODE
COLOR
CODE
ALUMINUM
SIL
BURGUNDY
BUR
LIGHT GREEN
LGR
RED
RED
AMETHYST
AME
CAMOUFLAGE BRO
IVORY
CRM
SILVER
SIL
BEIGE
BGE
CHROME
COM
LAVENDER
LAV
STAINLESS STEEL COM
BLACK
BLK
COPPER
CPR
MAROON
MAR
TAN
TAN
BLUE
BLU
CREAM
CRM
MAUVE
MAU
TAUPE
TAU
DARK BLUE
DBL
GOLD
GLD
PURPLE
PLE
TEAL
TEA
LIGHT BLUE
LBL
GRAY
GRY
MULTICOLOR
MUL
TURQUOISE
TRQ
BRONZE
BRZ
GREEN
GRN
ORANGE
ONG
WHITE
WHI
BROWN
BRO
DARK GREEN
DGR
PINK
PNK
YELLOW
YEL
CORRECTED SALVAGE OR SCRAP TITLE
A certification must be attached to an application for a corrected salvage title or scrap title describing the reason for correction.
USE TAX RETURN
Final determination of the correct tax liability is made by the Michigan Department of Treasury. You may be required to document your
tax return or prove you are entitled to the exemption claimed. If you cannot support your claim, minimum penalties include the added
tax, a negligence penalty, plus interest from the date of filing this application. Additional penalties can be imposed including criminal
prosecution or assessing up to 175% of the tax due.
“A person who violates a provision of this section with intent to defraud or to evade...the payment of a tax, or a part of the tax, is guilty of
a felony, punishable by a fine of not more than $5,000, or imprisonment for not more than 5 years, or both.” Sec. 27, Public Act 162 of
1980.
Exemption – Transfers Between Relatives: An exemption from use tax is allowed when the new owner is the spouse, father, mother,
brother, sister, child, stepparent, stepchild, stepbrother, stepsister, half-brother, half-sister, grandparent, grandchild, father- in-law,
mother-in-law, brother-in-law, sister-in-law, son-in-law, daughter-in-law, grandparent-in-law, legal ward, or legally-appointed guardian of
the previous owner. Documentation proving the relationship may be requested by the Michigan Department of Treasury.
THE SECTION PROVIDING FOR PAYMENT OF TAX IS COMPLETED AS FOLLOWS:
Line 1 – Enter the full purchase price or retail dollar value. The full purchase price includes the full amount paid to the previous owner
together with any outstanding debt owned. Such payment means money, credit, services rendered, trades or anything of value.
Line 2 – Enter 6% of the amount of line 1.
Line 3 – Enter any Sales or Use Tax paid in another state (including the tax paid to local government units) which is reciprocal with
Michigan. Submit proof.
Line 4 – Enter the amount of use tax due. If line 3 is completed, the tax due will be the difference between line 2 and the tax shown as paid
on line 3. In all other cases, line 4 will be the same as line 2.
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