Form Dor-Mv215 - Affidavit In Support Of Interstate Title (Nonnegotiable)

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SD EForm - 1333
V3
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SOUTH DAKOTA DIVISION OF MOTOR VEHICLES AFFIDAVIT
IN SUPPORT OF INTERSTATE TITLE (NONNEGOTIABLE) RECORD
AFFIANT NAME(S)________________________________ ADDRESS _______________________________________
________________________________ ADDRESS _______________________________________
VEHICLE/BOAT DATA YEAR______ MAKE______ SERIAL # ____________________________________________
LICENSE # ______________________ STATE______ TITLE #___________________ TITLED IN (STATE) _________
I hereby apply for regular South Dakota license plates for the above vehicle/boat as provided for under SDCL 32-5-4.1
and 32-3A-36, and affirm that the described vehicle/boat will be operated on this state's highways/waters. This
vehicle/boat is properly titled or registered under the laws of the state and license number listed above. I will retain the
Certificate of Title or registration form issued by the state of prior issuance, but have given a copy to the County Treasurer
for attachment to this affidavit. I request registration in the state of South Dakota for the reason indicated below: (Check
proper response)
Applicant is in state on a temporary basis.
Commercial vehicle titled out-of-state, but on lease to a South Dakota based motor carrier.
Military personnel temporarily stationed at a military base located within South Dakota.
South Dakota resident whose vehicle/boat is mortgaged by an out-of-state based financial service (mortgagor),
not applicable if out-of-state title is electronic (ELT).
I (We) hereby request that the Department of Revenue create a nonnegotiable Interstate Title record covering this
vehicle/boat in my (our) name(s), and that I (we) agree to protect and indemnify the South Dakota Department of
Revenue, Division of Motor Vehicles, against any and all liabilities and claims which may arise as a result of this title
registration.
Signature of Affiant(s) _______________________________________________________________________________
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(07-13)
PRINT FOR MAILING
CLEAR FORM

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