What is this form for?

This form is a request to the Motor Vehicle Division to place a lien on a vehicle belonging to a defendant for restitution.

Who fills out this form?

The form requires a signature and printed name from the Victim or Lienholder.

What must be enclosed with this form?

The form states that a certified copy of the Restitution or Pre-Conviction Restitution Lien must be enclosed.

AOCGN10F

MVD Request for Lien

Arizona · Arizona Judicial Branch · Effective July 30, 2018

This form is used to ask the Arizona Department of Transportation to place a lien on a defendant's vehicle. The lien is for restitution, which is money paid back for damages or losses.

Open the official PDFfrom Arizona Judicial Branch

Where this fits in a case

General & info

Information / general use — not tied to one step of a case

This form is used when a victim or lienholder needs to have a lien placed on a defendant's vehicle as part of a criminal case, following Arizona Revised Statutes § 13-806.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

What is this form for?: This form is a request to the Motor Vehicle Division to place a lien on a vehicle belonging to a defendant for restitution.
Who fills out this form?: The form requires a signature and printed name from the Victim or Lienholder.
What must be enclosed with this form?: The form states that a certified copy of the Restitution or Pre-Conviction Restitution Lien must be enclosed.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect July 30, 2018.

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