Affidavit Of Correction Form printable pdf download

Affidavit Of Correction Form

AFFIDAVIT OF CORRECTION

Form 78-008-10

Date: ___________________________

To Whom It May Concern:

The strikeover on the assignment of the attached Manufacturer’s Certificate of Origin or Certificate of Title for

the following described motor vehicle:

Year: ________________

Make: ________________________

Model: _________________________

Vehicle Identification Number (VIN): ____________________________________________________________

was made due to the following reason(s):

___ Typographical error

___ Assignment placed in dealer assignment in error

___ Customer changed mind

___ Notary Public placed signature in wrong space

___ Seller signed their name incorrectly

___ Purchaser’s name misspelled

___ Seller assigned title to wrong party

___ Seller made strikeover in purchaser’s name

___ Other: _________________________________________________________________________________

___________________________________________________________________________________________

Sworn to and subscribed before me this _______day of __________________________________, 20________.

_________________________________________

______________________________________________

Signature

Notary

__________________________________________

Seal

Notary Public’s Signature

IMPORTANT: The person(s) who was required to complete the assignment where the correction has been made

must complete this form. This form cannot be used when information has been blocked out by erasure or the use

of correction fluid/tape. In these cases, replacement documents must be obtained. This form cannot be used to

correct an odometer reading, a purchase date, or an incorrectly recorded lien, or security interest holder. For an

incorrectly recorded lien or security interest holder, a release of lien or security interest must be obtained by the

incorrectly recorded lien or security interest holder and submitted.

Title Bureau

P. O. Box 1033

Jackson, MS 39215

Phone 601-923-7643

FAX 601-923-7224

Affidavit Of Correction Form