Form 1940 - Limited Power Of Attorney Vehicle And Watercraft Transaction

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LIMITED POWER OF ATTORNEY
VEHICLE AND WATERCRAFT TRANSACTIONS
State Form 1940 (R4 / 5-13)
INDIANA BUREAU OF MOTOR VEHICLES
INSTRUCTIONS:
1. Complete in blue or black ink. If more than one customer’s signature is required, each customer must complete their own
Limited Power of Attorney section below.
2. Individuals must enter their residential address; companies must enter their principal place of business.
3. The Limited Power of Attorney form must be notarized to be valid.
4. The Limited Power of Attorney designation is valid for ninety (90) days from the date of notarization.
 
I, _______________________________________________, residing/located at______________________________ in the
county of
_________________, State of _____________, do hereby appoint ________________________________________________
as my attorney-in fact for a period of ninety (90) days from the notary date. I authorize the attorney-in-fact to complete transactions involving
the certificate of title and/or registration for the vehicle / watercraft described below.
Vehicle or Hull Identification Number
Make of Vehicle / Watercraft
Year
Title Number (if known)
Customer’s Signature
Customer’s Printed Name
Date (mm/dd/yyyy)
NOTARY CERTIFICATE
 
STATE OF ____________________________________________ 
                                                                                                                                           SS:                                   (SEAL) 
COUNTY OF __________________________________________ 
 
Sworn to before me, a Notary Public, in and for said County, this __________day of____________________________, 20_____.
Signature of Notary Public
Printed or Typed Name of Notary Public
Date Commission Expires (mm/dd/yyyy)
I, _______________________________________________, residing/located at______________________________ in the
county of
_________________, State of _____________, do hereby appoint ________________________________________________
as my attorney-in fact for a period of ninety (90) days from the notary date. I authorize the attorney-in-fact to complete transactions involving
the certificate of title and/or registration for the vehicle / watercraft described below.
Vehicle or Hull Identification Number
Make of Vehicle / Watercraft
Year
Title Number (if known)
Customer’s Signature
Customer’s Printed Name
Date (mm/dd/yyyy)
NOTARY CERTIFICATE
 
STATE OF ____________________________________________ 
                                                                                                                                           SS:                                   (SEAL) 
COUNTY OF __________________________________________ 
 
Sworn to before me, a Notary Public, in and for said County, this __________day of____________________________, 20_____.
Signature of Notary Public
Printed or Typed Name of Notary Public
Date Commission Expires (mm/dd/yyyy)

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