POWER OF ATTORNEY
I (We) ________________________________________________________________________________,
of _____________________________________________________________, am (are) the legal owner(s)
of the following vehicle:
Year:
______________
Type:
__________________________________________
Make:
__________________________________________
VIN:
__________________________________________
License Number: __________________________________________.
By this instrument, I (we) appoint __________________________________________________________
of _________________________________ County, as my (our) attorney in fact to sign my (our) name(s)
and complete information in relation to transactions involving the certificate of title or registration for the
vehicle as described above.
WITNESS(ES):
SIGNATURE(S):
______________________________________
____________________________________
Witness
Signature
______________________________________
____________________________________
Witness
Signature
______________________________________
____________________________________
Claim Number
Date
NOTARY:
State of ____________________________________ ; County of ______________________________; SS
On this ________ day of _____________________, 20_____, before me appeared ___________________
______________________________________________________________________________________
who is known to be the person(s) named herein and who voluntarily executed this release.
_____________________________________
____________________________________
Notary Signature
Date Commission Expires
Form 1020F