Declaration Form Of Non-Ownership (Or Lease/rental)
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1City of Beverly Hills
DECLARATION OF NON-OWNERSHIP
(OR LEASE/RENTAL)
INSTRUCTIONS: Complete this form if you have been charged with parking violations
issued to a vehicle which had been legally sold, leased, or rented at the time the violation
occurred. Under California Vehicle Code, Section 40200, it is presumed that the registered
owner of the vehicle was the person who parked it illegally. You were listed at the DMV as
the registered owner on the date of the violation(s). If you did not own the vehicle on that
date, complete the declaration below and return to the following address:
City of Beverly Hills
P.O. Box 515258
Los Angeles, CA 90051-6558
The undersigned declares that the vehicle bearing the license plate number listed below was not
owned by me on the violation date. The vehicle was: (Check only One)
__ 1. Sold to someone else
You must provide evidence of a bona fide sale or transfer (a copy of the Bill of Sale or Release of
Liability filed with the DMV which includes the name and address of the purchaser and the date of
sale) with this completed Declaration within 21 days of the notice date on the front of this form.
__ 2. Leased/rented under a written agreement
Proof of a written lease or rental agreement, which includes the complete name, address, and
driver's license number of the person to whom the vehicle was leased or rented, must be submitted
within 30 days of the notice date on the front of this form.
__ 3. Not yet purchased by me.
You must provide evidence of a bona fide sale or transfer (a copy of the Bill of Sale or Release of
Liability filed with the DMV which includes the name and address of the seller and the date of the
sale) with this completed Declaration within 21 days of the notice date on the front of this form.)
__ 4. Described incorrectly.
You must enclose a copy of the registration to prove this statement.
License Plate # (include state): ____________________________________________________
Citation #(s): ___________________________________________________________________
NAME AND ADDRESS OF THE RESPONSIBLE PARTY (PLEASE PRINT):
Name: _________________________________ Driver’s License: _______________________
Street: ________________________________________________________________________
City/State/Zip Code: ____________________________________________________________
Date the sale, purchase, or lease/rental was executed: _________________________________
I declare under penalty of perjury that the foregoing is true and correct.
_______________________________________
_____________________________
(Signature)
(Date)
Dec-of Non Form
6/2003
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