Sd Eform 1792 V1 - Four Wheel, All Terrain Vehicle Affidavit
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1SD EForm - 1792
V1
Complete and use the button at the end to print for mailing.
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FOUR WHEEL, ALL TERRAIN VEHICLE AFFIDAVIT
( Attach to Title and Registration Application )
I, the undersigned, do hereby swear that I had installed on the following described four wheel, all terrain vehicle:
Make _________________________________________
Title Number _______________________________
Model _________________________________Year________________ Serial Number ___________________________________
by ________________________________________________________________________________________________________
(name and address of person installing accessories) the following motorcycle accessories, not to be exclusive:
______ Rearview Mirror
______ Headlights
_______200 cc Engine
______ Horn
______ License plate light
_______Other (list)
______ Exhaust & Muffler
______ Parking lights,
_________________________________
tail lights, stop lights
_________________________________
I further swear that the above described vehicle is insured pursuant to SDCL Chapter 32-35, and the accessories meet the
motorcycle standards of SDCL Chapters 32-15, 32-17, and 32-18. I also declare and affirm under the penalties of perjury that
this affidavit has been examined by me and to the best of my knowledge and belief is in all things true and correct.
Name:____________________________________________
Date:_____________________________________________
Signed and sworn to before me this ______ day of ___________________________________________________ , 20 _______
____________________________________________________________________
Notary
My Commission expires on the ________day of
__________________________________________ , 20 ________
Pursuant to SDCL 32-20-2 to operate the above vehicle you must have a valid driver’s license.
1.
PRINT FOR MAILING
CLEAR FORM
DOR:MV:304 (7-03)
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