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Get ID ITD 3410 2009

Indemnifying Affidavit ITD 3410 Rev. 07-13 Supply 01-958056-2 Idaho Transportation Department Vehicle Services Vehicle/Hull Identification Number Year itd. idaho. gov Make Model Zip Date Purchased Vehicle/Vessel Purchased From Address City State I the undersigned acknowledge it is a felony to make a false statement in this affidavit Section 49-518 Idaho Code. I certify that the above-described vehicle/vessel is free from all liens and encumbrances except as set forth in my application for Idaho Certificate of Title. I am entitled to possession and ownership of the vehicle or vessel because If the vehicle described above was imported from another country I certify that the vehicle is now in Idaho. If the vehicle was commercially imported I certify that to the best of my knowledge all U*S* DOT Federal Motor Vehicle Safety Standards EPA and US Customs and Border Protection requirements have been or will have been satisfied within the required timeframe. If the vehicle was imported for personal use from Canada I certify that I am aware that I may be assessed a civil penalty up to 5 000 and/or the vehicle may be seized by the US Customs and Border Protection if the vehicle has not met their entry requirements prior to the registration and/or titling of this vehicle. I accept full responsibility for complying with all U*S* DOT Federal Motor Vehicle Safety Standards EPA and US Customs and Border Protection requirements. neighborhood electric vehicle NEV and no title or Manufacturer s Statement of Origin MSO or Manufacturer s Certificate of Origin MCO is being submitted I certify that no MSO or MCO exists and that the vessel or vehicle has never been titled unless otherwise indicated below. Other Pertinent Facts This affidavit is attached to and made a part of my application for Idaho Certificate of Title to the above-described vehicle/vessel* I do hereby agree to warrant and defend said Title and to not only save harmless and defend regardless of outcome the Idaho Transportation Department ITD from the expenses of and against all suits actions claims losses or assertion of claims including costs expenses and attorney fees to which the department may be subjected on account of any defect in my Title to the vehicle/vessel in question but also to pay any and all damages suffered by any person or entity resulting from the issuance of this title by the Idaho Department of Transportation* I certify under penalty of perjury pursuant to the law of the State of Idaho that the foregoing is true and correct and that the signature below is my true and legal signature. Printed Full Legal Name / Business Name Owner s Physical Address / Business s Physical Address Owner / Business Representative s Signature X Owner s Idaho Driver s License Number or SSN / Business s EIN Date Daytime Phone Number. idaho. gov Make Model Zip Date Purchased Vehicle/Vessel Purchased From Address City State I the undersigned acknowledge it is a felony to make a false statement in this affidavit Section 49-518 Idaho Code. I certify that the above-described vehicle/vessel is free from all liens and encumbrances except as set forth in my application for Idaho Certificate of Title. .

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