Power Of Attorney To Obtain A Title Registration On A Motor Vehicle And/or Affidavit Of Refund

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POWER OF ATTORNEY TO OBTAIN A TITLE
REGISTRATION ON A MOTOR VEHICLE AND/OR
AFFIDAVIT OF REFUND
: __________________________________
I, THE UNDERSIGNED, HEREBY APPOINT
AS MY ATTORNEY-IN-FACT TO SIGN AND/OR ENDORSE ALL
DOCUMENTS IN ANY NAME NECESSARY TO TITLE AND/OR REGISTER,
TO RENEW LICENSE STICKER, CHANGE ASSRESS, APPLY FOR
REPLACEMENT OF LOST OR STOLEN LICENSE PLATES, TITLES AND
REGISTRATION CERTIFICATES FOR THE VEHICLE DESCRIBED BELOW.
I, HEREBY GRANT PERMISSION TO THE STATE OF LOUISIANA TO REFUND MONIES PAID
ON MY BEHALF BY _____________________________
TO INCLUDE, BUT NOT LIMITED TO, SALES TAX, LICENSE FEES, AND TITLE FEES, TO
THE ABOVE.
LICENSE NUMBER
VIN#
YEAR
MAKE
MODEL
BODY
COLOR
MILEAGE
___________________________
______________________________
WITNESS
PURCHASER
SWORN TO AND SUBSCRIBED BEFORE
ME THIS ________ DAY OF____________________20___.
________________________________________
NOTARY PUBLIC

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