Form Dor-Mv215 - Affidavit Of Vehicle Repossession
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1SD EForm - 1335
V2
HELP
Complete and use the button at the end to print for mailing.
SOUTH DAKOTA DIVISION OF MOTOR VEHICLES
AFFIDAVIT OF VEHICLE REPOSSESSION
AFFIANT NAME(S)________________________________ ADDRESS _______________________________________
________________________________ ADDRESS _______________________________________
VEHICLE/BOAT DATA YEAR______ MAKE______ SERIAL # ____________________________________________
LICENSE # ______________________ STATE______ TITLE #___________________ TITLED IN (STATE) _________
This is to certify that on the______ day of ______________________________________________________ , 20___ the
undersigned did lawfully repossess the vehicle as described above from___________________________________
of _________________________________ , because of the failure of the debtor to fulfill his/her obligation according to
the terms of the encumbrance on said vehicle. That I (we) make this affidavit for the purpose of establishing ownership to
said vehicle in order to obtain a Certificate of Title hereto under the laws of the state of South Dakota. I (we) further state
that in consideration of the issuance of the transfer of certificate of title applied for, I (we) hereby agree to indemnify the
Secretary of the Department of Revenue and all persons acting for him from any and all liability that may occur by the
issuance of such certificate and agree at my expense to defend any suit that may be brought against the Secretary or any
person acting for him as a result of issuing such certificate.
Signature of Affiant ________________________________ On behalf of ______________________________________
(Name of Lienholder)
Please check applicable box:
Lienholder
Address _____________________________________
ELT
Certificate of title
is
is not available
STATE OF SOUTH DAKOTA
_________________________________________________
COUNTY OF____________________________________ SS.
Notary Public or County Treasurer
Subscribed and Sworn to before me this _________________
_________________________________________________
day of _____________________________________ ,20 ___
Date Commission Expires
DOR-MV215(05-12)
PRINT FOR MAILING
CLEAR FORM
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