Service Oklahoma - Motor Vehicle Services
In Lieu of Replacement Title Affidavit
Insurance Company Afdavit for Issuance of a Salvage or Junk Certicate of Title
Pursuant to Title 47 Section 1105(H) of the Oklahoma Statutes.
Refer to Page 2 for Important Information Relating to this Afdavit.
Form 780-A
Revised 01/2023
This in lieu of replacement title afdavit is presented on behalf of:
Name of Insurance Company: ______________________________________________ FEIN: ___________________
Address of Insurance Company: ______________________________________________________________________
_____________________________________ _______ ____________________
City State Zip
Daytime Phone: _____________________ Email Address: _______________________________________________
for issuance of a (select one): Salvage Certificate of Title Junk Certificate of Title
on the following vehicle: Year: ________ Make: _____________________ Model: __________________________
Vehicle Identication Number (VIN): _ ___________________________________________________________________
Oklahoma Title Number: _____________________________________________________________________________
Insured Owner’s Name: _____________________________________________________________________________
This affidavit is made pursuant to the provisions of 47 O.S. § 1105(P) in lieu of securing a replacement title in the name of
the insured and following a total loss settlement with the insured.
• Date of Total Loss Settlement Acceptance: ____________________________________
My signature below afrms the above information is accurate to the best of my knowledge and belief and that I am autho-
rized by the insurance company listed above to submit this afdavit on their behalf.
Signature of Authorized Insurance Company Representative: ________________________________________________
Notary Seal
State of ____________________________ , County of _____________________________________
Subscribed and sworn to before me this _____________ day of ___________________ , __________ .
My commission expires:
______________________ , _______________ .
______________________________________________________________________ , Notary Public
Submit or mail this completed affidavit and remittance, made payable to Service Oklahoma, to any Oklahoma tag agent. A
listing of agent locations is available in the Motor Vehicle Overview Section of the Service Oklahoma website at
https://service.ok.gov. If you choose to mail your affidavit and payment to Service Oklahoma, please send to the
address on page 2 of this form.
MVC
Fee $22.00
Form 780-A - Page 2
Service Oklahoma/Motor Vehicle Services
In Lieu of Replacement Title Affidavit
Purpose of Form
This af
davit is to be utilized by an insurance company, or their authorized representative, in applying for an Oklahoma Sal-
vage or Junk certificate of title to a vehicle following settlement of a total loss claim, in lieu of securing a replacement title
in the name of the insured, pursuant to the provisions of 47 O.S. § 1105(H), which state, in pertinent part:
When an insurer requests a salvage or junk title in the name of the insurer resulting from the settlement of a total loss
claim and upon presentation of appropriate proof of loss documentation as required by Service Oklahoma, such
transfer may be processed as one title transaction, without first requiring issuance of a replacement certificate of title in
the name of the vehicle owner. The fee shall be Twenty-two Dollars ($22.00). Two Dollars ($2.00) of this fee shall
be deposited in the Service Oklahoma Reimbursement Fund.
Insurance Company Damage Notication
Insurance companies paying a claim for a loss where the cost of repairing the vehicle for safe operation on the highway
exceeds sixty percent (60%) of the market value of the vehicle, or paying a claim for a flood-damaged vehicle as defined
in Title 47 Section 1105, must notify, in writing, both the record owner and Service Oklahoma. 47 O.S. § 1111(L)
states, in pertinent part:
L. Any insurance company that pays a claim for a loss where the cost of repairing the vehicle for safe operation on the
highway exceeds sixty percent (60%) of the market value of the vehicle or pays a claim for a flood-damaged vehicle as
defined in Section 1105 of this title shall notify, in writing, the holder of the certificate of title of the requirements of this
section and shall notify Service Oklahoma of the payment of such claim. The notice shall include the estimated total
damage percentage determination of the actual cash value made by the insurance company to repair the vehicle for
safe operation on the highway. The insurance company shall also send a copy of the notification to the holder of the
title.
This damage percentage is used by Service Oklahoma in determining the proper title type (i.e. Salvage or Junk) to be
issued. Flood Damage, when noted, will be reflected as a brand on the Oklahoma Certificate of Title.
• A Salvage title is required when the damage percentage is from 60% to 79%.
• A Junk tile is required when the damage percentage is 80% or greater.
• A Flood Damaged brand is to be added, when applicable.
Title 47 Section 1105 denes a Flood-Damaged V
ehicle as a salvage or rebuilt vehicle which was damaged by ooding,
or a vehicle which was submerged at a level to or above the dashboard of the vehicle and on which an amount of loss was
paid by the insurer.
Note: As outlined in the statutory language excerpted above, only damage impacting the roadworthiness of the vehicle need
be considered in this notification to Service Oklahoma. Cosmetic damage (i.e. hail) unrelated to roadworthiness should not
be included in this damage computation. Flood damage criteria is outlined immediately above.
Contact Information
Questions regarding the use of this affidavit, or any issue relating to insurance loss damage declarations, may be
directed to the Motor Vehicle Services of Service Oklahoma at (in state toll free) 800-522-8165, or (direct) 405-521-3221.
Mailing address:
Service Oklahoma
PO Box 26940
Oklahoma City, OK 73126-0940
Copies of this affidavit may be downloaded from the Service Oklahoma website at https://service.ok.gov.
