Form DR 2393 template
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Statement of Repossession and Certificate of Extension of Chattel Mortgage
[DR 2393 and DR 2004 forms] These documents combine several forms: Statement of Repossession, Certificate of Extension of Chattel Mortgage, and Floor Plan Declaration. The Statement of Repossession includes details such as lienholder name, date of lien, amount of lien, agent's name, date received, delinquent date, possession date, and Vehicle Identification Number (VIN), year, make, body model. The Certificate of Extension of Chattel Mortgage provides information about the extension filed date, amount of secured unpaid debt, and lienholder's signature. The Floor Plan Declaration states that the lienholder is the owner and holder of a note secured by a chattel mortgage against a dealer, includes VIN, year, title number, UCC filing number, dealer name, and agent's signature.
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