General Affidavit For Mv Form
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1Affidavit
The undersigned hereby certifies the following fact(s) regarding vehicle/vessel described:
Make _________Year _______ ID # ____________________________________Title
_____________________
1. _______
My name was entered in error as purchaser on the above title. I have never had possession or any interest in
this vehicle/vessel.
2. _______
The name_______________________________ was entered in error as purchaser. This person never took
possession and vehicle /vessel was resold to ______________________________ for __________________.
3. _______
My name was entered in error as lien-holder on above title. I do not hold any lien against this vehicle/vessel.
4. _______
The names ______________________________________ and ____________________________________
shown on the attached papers identify one and the same person.
5. _______
Military Non-resident, my state of residency is _________________________________________________
6. _______
The above vehicle has not been/will not be operated upon the public highways of Florida or has been sold or
disposed of.
7. _______
The above vessel has not been operated upon the public waterways of Florida for 12 or more months.
8. _______
There is an odometer discrepancy because ____________________________________________________
_______________________________________________________________________________________
9.
_______
The identification number that appears on the Florida title is incorrect. I visually inspected the identification
number on the vehicle/vessel and found it to be the following: _____________________________________
10. _______
As owner of the above vehicle, I request the vehicle be classified as a recreational vehicle as the following
has been installed:
( ) 110 volt electrical wiring
( ) LP gas piping
( ) Plumbing system
11. _______
I am the lawful owner of the above vehicle; the _________________________ body has been removed and
____________________________ body installed; title is herewith surrendered for correction of vehicle type.
12. _______
After a thorough visual inspection of the above vessel, I have been unable to locate any existing hull
identification number on the vessel.
13. ________ The license plate __________________ is (check one) ____ Lost ____ Stolen ____ Destroyed. If recovered,
the plate will not be used on any motor vehicle. I understand if I replace the plate I must pay any required
fees (approximately $43.15, if current).
Other _________________________________________________________________________________
14. _________
_______________________________________________________________________________________
_______________________________________________________________________________________
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
Show Date
Clear Date
Date: _____________________
Print
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________________________________
___________________________________
Affiant
Affiant
Revision Date 06/05
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