Form 1940 - Power Of Attorney printable pdf download

Form 1940 - Power Of Attorney

POWER OF ATTORNEY - STATE OF INDIANA

State Form 1940 (R3/2-00)

PLEASE PRINT

I / We, ____________________________________________ , residing at ______________________________________________ in the county of

_________________________ do hereby appoint __________________________________________ as my/our attorney in fact to sign my/our name(s)

and complete information in relation to transactions involving the certificate of title or registration for the vehicle / watercraft as described below:

Make of vehicle / watercraft

Vehicle or Hull I.D. number

Title number

Year

Printed or typed name of owner

Signature of owner

NOTE: Social Security / Federal ID

numbers are not required on power-

of-attorney form but are required for

Signature of owner

Printed or typed name of owner

title and registration applications.

NOTARY CERTIFICATE

STATE OF

}

SS:

(SEAL)

COUNTY OF

Sworn to before me, a Notary Public, in and for said County, this __________ day of ________________________________ , 20 ____ .

Printed or typed name of Notary Public

Date commission expires

Signature of Notary Public

NOTE: In accordance with Indiana Code 30-5-4-1, all power-of-attorney forms must be notarized. Special deputies of the Bureau of Motor Vehicles may,

in lieu of a notary, sign power-of-attorney forms used in Indiana for Bureau of Motor Vehicles transactions. Special deputy verifications are valid only on

Bureau of Motor Vehicles documents in Indiana and are not recognized for interstate transactions.

Special Deputy Bureau of Motor Vehicles, State of Indiana Chapter 01 Acts 1847

Date (month, day, year)

By: