Fillable Declaration Of Non-Ownership (Or Lease / Rental) Form printable pdf download

Declaration Of Non-Ownership (Or Lease / Rental) Form

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City of Santa Monica

DECLARATION OF NON-OWNERSHIP (OR LEASE / RENTAL)

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INSTRUCTIONS: Under California Vehicle Code, Section 40200, the registered owner of the vehicle is

responsible for the parking citation(s) issued. You were listed at the DMV as the registered owner on the date of

the violation(s). If you did not own the vehicle on that date, please complete the declaration below. In

addition, you must submit one of the following, as may be applicable to your claim.

A copy of the “Notice of Transfer and Release of Liability” form that was filed with the DMV at the time of

sale/transfer of the vehicle (name and address required);

Bill of Sale / Lease Agreement / Rental Agreement from a licensed car dealer / leasing company / rental car

company. Proof of private party sales are accepted with a Release of Liability that is filed with DMV;

A copy of an IRS approved vehicle donation document;

Repossession papers showing that the car was repossessed prior to the ticket issue date;

Any DMV certified documentation that shows the vehicle was not in your possession at the time the citation

was issued;

Certification of Lien Sale or Notice of Pending Lien Sale and Computerized Vehicle Registration (CVR).

THIS DECLARATION WILL NOT BE VALID UNLESS ALL THE INFORMATION BELOW IS COMPLETED,

DATED, AND SIGNED.

Responsible Party Information: (PLEASE PRINT LEGIBLY)

Name _____________________________________________________________________________________

Street_____________________________________________________________________________________

City/State/Zip Code __________________________________________________________________________

Date of sale, purchase, or lease/rental was executed (MM/DD/YYYY) ___________________________________

License Plate Number ___________________ Complete VIN _________________________________________

CITATION NUMBER(S) _______________________________________________________________________

I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.

Signature __________________________________________________________ Date ___________________

Your Name _________________________________________________________________________________

Your contact information:

Street Address______________________________________________________________________________

City/State/Zip Code __________________________________________________________________________

SEND YOUR COMPLETED FORM AND ALL SUPPORTING DOCUMENTATION TO:

City of Santa Monica

P.O. Box 515214

Los Angeles, CA 90051-6514

Declaration Of Non-Ownership (Or Lease / Rental) Form

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