Form T-11 - Affidavit Of Correction

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T-11 (Rev.07-2005)
Affidavit of Correction
Date: ___________________________
TO WHOM IT MAY CONCERN:
The strikeover on the assignment of the attached Manufacturer’s Certificate of Origin or Certificate of Title for the
following described vehicle:
____________________________________________________________________________________________
(Year Model, Make of Vehicle and Vehicle Identification Number)
was made due to the following reason(s):
Typographical error
Assignment placed in Dealer Assignment in error
Customer changed mind
Notary Public placed signature in wrong space
Seller signed their name incorrectly
Purchaser’s name misspelled
Seller assigned title to himself
Other _________________________________
Seller assigned title to wrong party
______________________________________
Seller made strikeover in purchaser’s name
______________________________________
______________________________________
Sworn to and subscribed before me
this ________ day of __________________, __________
______________________________________
(Day)
(Month)
(Year)
(Signature)
______________________________________________
______________________________________
(Notary Public’s Signature & Notary Seal/Stamp)
(Date Notary Commission Expires)
Important:
The person(s) who was required to complete the assignment where the correction has been made must complete this form. This
form cannot be used when information has been blocked out by erasure or the use of correction fluid. In these cases,
replacement documents must be obtained. This form cannot be used to correct an odometer reading, a purchase date or an
incorrectly recorded lien or security interest holder. For an incorrectly recorded odometer reading, Form T-107 (Odometer
Discrepancy Affidavit) must be completed and submitted. For an incorrectly recorded lien or security interest holder, Form T-4
(release of lien or security interest) must be completed by the incorrectly recorded lien or security interest holder and submitted.
Alterations of the purchase date result in the assessment of a $10.00 title penalty.
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