T-23 (Rev. 11-2009)
Department of Revenue
Processing Center-Motor Vehicle
Homemade Trailer Affidavit
Personally appeared before me, the undersigned, who being duly sworn, states that
he and/or she is the legal and rightful owner(s) of the trailer described below, such
trailer having been built by:
___________________________________________________________________
(Builder’s Full Legal Name)
and completed on the _______day of _____________, _______. I/we further state
(Day)
(Month)
(Year)
that this trailer is free and clear of all liens, security interests and encumbrances and
the materials used in its construction have been paid for prior to this date.
__________________________ ___________________
________________
(Type Trailer, i.e. 8’ X 10’ utility, etc.)
(Year Model – Year Built)
(Weight – Empty)
_____________________________
___________
______________________
(Owner(s)’ Full Legal Name(s): (First Name)
(Middle Name)
(Last Name)
______________
______________
_______
______________________
(City)
(State)
(Zip)
(County of Residence)
Sworn to and subscribed before me this
The ____Day of_____________, ______
____________________________
(Day)
(Month)
(Year)
(Owner(s)’ Signature(s)
_________________________________
____________________________
(Notary Public’s Signature & Notary Seal or Stamp)
(Date)
__________________________________
(Date My Notary Commission Expires)
Clear form
Print this form!
Any Correction or Alteration Will Void This Form