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Get MS Affidavit Of Ownership Of Motor Vehicle For Which Application For Title Under Bond Or Cash Is 2018-2022

Was there a license tag on the vehicle when you acquired it If so give state name and tag number. Instructions The vehicle described herein must be taken to the nearest Mississippi Department of Public Safety substation for inspection and issuance of Form MVT-59 by the inspecting officer prior to making application for certificate of title. Mississippi Form 79-013-02-1-1-000 Rev. 11/02 STATE TAX COMMISSION TITLE BUREAU - POST OFFICE BOX 1383 JACKSON MS 39215 AFFIDAVIT OF OWNERSHIP OF A MOTOR VEHICLE FOR WHICH APPLICATION FOR TITLE UNDER BOND OR CASH IS MADE. MVT-59 from Department of Public Safety Required FAILURE TO PROVIDE ALL REQUIRED INFORMATION MAY RESULT IN YOUR APPLICATION BEING REJECTED. If affiant is a licensed dealer he must be principal in the bond. THE STATE OF MISSISSIPPI COUNTY OF Before me the undersigned has this day appeared of Street Address who after being duly sworn deposes and states that he she is the legal City State Zip owner by virtue of the attached bill of sale of the following described vehicle Year Make Body Style and states that said vehicle was acquired from whose address Enter Name of Person You Acquired Vehicle From Attach Bill of Sale Zip. Telephone number at which the seller may be reached. In what state Required was the herein described vehicle last registered In your own words state the reason you are unable to surrender the current certificate of title of the vehicle. FEDERAL and STATE LAW requires that you state the mileage in connection with the transfer of ownership* Failure to complete or providing a false statement may result in fines and/or imprisonment. and to the best of my knowledge that it reflects the actual mileage of the vehicle described herein unless one of the following is checked 1. I hereby certify to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits. Signature Printed Name Sworn and subscribed this day of 20 This form is required to be submitted with all Applications for Certificate of Title made under Title Bond. If affiant is a licensed dealer he must be principal in the bond. THE STATE OF MISSISSIPPI COUNTY OF Before me the undersigned has this day appeared of Street Address who after being duly sworn deposes and states that he she is the legal City State Zip owner by virtue of the attached bill of sale of the following described vehicle Year Make Body Style and states that said vehicle was acquired from whose address Enter Name of Person You Acquired Vehicle From Attach Bill of Sale Zip. Telephone number at which the seller may be reached. In what state Required was the herein described vehicle last registered In your own words state the reason you are unable to surrender the current certificate of title of the vehicle. FEDERAL and STATE LAW requires that you state the mileage in connection with the transfer of ownership* Failure to complete or providing a false statement may result in fines and/or imprisonment. and to the best of my knowledge that it reflects the actual mileage of the vehicle described herein unless one of the following is checked 1.

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