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All highlighted areas must be completed or the form may not be processed. SWORN AFFIDAVIT FORM STATE OF INDIANA DEPARTMENT OF REVENUE COMPIANCE DIVISION-AERONAUTICS P. O. Box 644 Indianapolis Indiana 46206-0644 317 232-1497 INSTRUCTIONS Sworn Affidavit Form or copy of Bill of Sale signed by seller is due at time of Application for Registration or a Proposed Assessment will be issued using the average retail value.

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