Get FL HSMV 83080 2011-2024

Flhsmv.gov/offices/ MOTOR VEHICLE REGISTRATION ELIGIBILITY AFFIDAVIT / APPLICATION APPLICANT INFORMATION Owner s Name Owner s Sex For company show C for sex Date of Birth expiration month Street Address City State Co-Owner s Sex For company Zip Owner s Driver s License or FEID/Suffix Number Co-Owner s Driver s License or FEID/Suffix Number Lessee s Name Lessee s Sex Lessee s Driver s License or FEID/Suffix Number VEHICLE INFORMATION Current Decal Number Vehicle Identification Number Florida Title Number Current Florida License Plate Number Make of Vehicle Year Type of Vehicle Color Weight of Vehicle CERTIFICATION OF ELIGIBILITY I hereby certify my eligibility for the following check the appropriate box listed below Date Disabled Veteran or Disabled Veteran Wheelchair license plate Non-resident Military Enclosed is a copy of my current orders which certify that my nonresident status has not changed. 90-Day Temporarily Employed My signature below certifies that I am temporarily employed in Florida. Forestry Products My signature below certifies that I am hauling unprocessed forestry products within a 150 mile radius of the above described vehicle s home address. STATE OF FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES DIVISION OF MOTORIST SERVICES SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE www. Agricultural or Horticultural Products My signature below certifies that the above described vehicle is not being operated as a for-hire vehicle and I am hauling unprocessed agricultural or horticultural products within a 150 mile radius of the above described vehicle s home address. X-Series license plate Other Under penalties of perjury I certify and declare that I have read the foregoing document and that the facts stated in it are true. SIGNATURE OF APPLICANT OWNER Check your local phone book government pages or visit the following website for current mailing addresses http //www. Agricultural or Horticultural Products My signature below certifies that the above described vehicle is not being operated as a for-hire vehicle and I am hauling unprocessed agricultural or horticultural products within a 150 mile radius of the above described vehicle s home address. X-Series license plate Other Under penalties of perjury I certify and declare that I have read the foregoing document and that the facts stated in it are true. X-Series license plate Other Under penalties of perjury I certify and declare that I have read the foregoing document and that the facts stated in it are true. SIGNATURE OF APPLICANT OWNER Check your local phone book government pages or visit the following website for current mailing addresses http //www. Agricultural or Horticultural Products My signature below certifies that the above described vehicle is not being operated as a for-hire vehicle and I am hauling unprocessed agricultural or horticultural products within a 150 mile radius of the above described vehicle s home address. X-Series license plate Other Under penalties of perjury I certify and declare that I have read the foregoing document and that the facts stated in it are true. SIGNATURE OF APPLICANT OWNER Check your local phone book government pages or visit the following website for current mailing addresses http //www. .