Mississippi Department of Transportation Outdoor Advertising Management System
Please login to use this form
MISSISSIPPI DEPARTMENT OF TRANSPORTATION
NOTIFICATION OF OWNERSHIP TRANSFER

Location of Sign

Choose Permit No.:
v
County: Highway Number:
City: Distance from Right of Way:
Distance from Intersection: Direction from Intersection:
Route of Nearest Intersecting Highway : Side of road:

LandOwner

First Name:
Middle Initial:
Last Name:
Street Address:
City:
State:
v
Zip Code:
Phone Number:

New Sign Owner Identification

Select Sign Owner:
v
Company Name:
First:
Middle Initial:
Last:
Street Address:
City:
State:
v
Zip Code:
Phone Number:
Email:
PHYSICAL DESCRIPTION OF SIGN SHALL REMAIN THE SAME AS ON THE DATE OF PURCHASE :
Current Sign Message:
The above sign was purchased on _____________________, 20__, from ____________________
Mail this Notification of Transfer of Outdoor Advertising to :
Mississippi Department of Transportation
Attn: Maintenance Division 75-01 
P.O. Box 1850 
Jackson, MS 39215-1850
                                        
Please enclose a letter of bill of sale releasing the above sign from the previous sign owner.
Signature of New Owner__________________________________ Date_______________________________