Non-Dealer Transfer Affidavit Form
Affidavit for individuals attesting to a vehicle transfer that occurred without a dealer. Please complete all sections accurately.
Transferor Full Name
*
First Name
Last Name
Transferee Full Name
*
First Name
Last Name
Vehicle Identification (Year, Make, Model, VIN)
*
Describe the circumstances of the transfer
*
Date of Sale/Transfer
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Consideration Amount (USD)
*
Current possession/status of the vehicle
*
Odometer Reading (miles)
*
Signature of Transferor or Authorized Representative
*
Submit Affidavit
Submit Affidavit
Should be Empty: