ALL PURPOSE AFFIDAVIT
__________ _________ __________________________________________
MAKE YEAR VIN IDENTIFICATION NUMBER
__________________ ________________
TITLE # TYPE
___The name of ____________________________________ and __________________________________
are one and the same.
___The name _______________________________was entered on the title in error and he/she did not
take possession if the vehicle described above.
___The actual date of sale was ___________________not_________________.
___The vehicle described above will not be operated in the public highways of the State of Florida.
___The vehicle described above has been continuously maintained in dead storage and has not been operated
during the previous registration period.
___Applicant swears of affirms that he/she is temporarily employed in the State of Florida.
___The vehicle described above was actually sold to ____________________
on
____________
for the sum of $________________.
___ License plate #________________is lost, destroyed or stolen, if found the license plate will not be affixed
to any motor vehicle.
___ Surrendering plate # ___________ for customer____________. My license number is____________________.
(please include a photocopy of the customers drivers license.)
___ I no longer own this vehicle as of ______________.
___ I am the manufacturer of this homemade trailer, complete on ________. It has an empty weight of _______lbs
and has never been titled or registered in any state.
___ Exempt mileage
OTHER:
Under penalties of perjury, I declare that I have read the foregoing document and the facts
stated are true and correct.
__________________________ ____ _______________________ ____
Signature of Owner Date Signature of Co-Owner Date
__________________________ _______________________
Printed Name Printed Name
