Form Mvd-10012 - Affidavit Of Repossession

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MVD - 10012
State of New Mexico - Motor Vehicle Division
REV. 06/90
AFFIDAVIT OF REPOSSESSION
VEHICLE / VESSEL INFORMATION
Year
Make
Model
Type
State Registered
Engine No. (If Applicable)
Vehicle/Hull ID Number
Lic. Plate or Boat No.
REGISTERED OWNER INFORMATION (As Shown on Encumbered Title)
Name
Address
City, State, Zip Code
LIENHOLDER INFORMATION (As Shown on Encumbered Title)
Name
Title Number
Address
City, State, Zip Code
I certify that all steps required by law in connection with such repossession, including proper notice of sale, have
been duly and properly complied with and that all information given herein is true and correct to the best of my
knowledge.
Signature of Lienholder or Authorized Agent
Date

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