Page 1 of 1 Affidavit of Non-Ownership Registration/Insurane R 12/17/2020 AFDV IN THE COUNTY COURT FOR THE SIXTH JUDICIAL CIRCUIT IN AND FOR PASCO COUNTY, FLORIDA STATE OF FLORIDA vs. CITATION: CASE: AFFIDAVIT OF NON-OWNERSHIP REGISTRATION / INSURANCE I, the undersigned, do hereby swear or affirm that under the penalty of perjury and possible contempt of court, that having been charged with: No insurance No tag/registration on the following vehicle: Year: Make: Model: Color: Do not have the required proof as required by statute and that I am unable to obtain this proof due to the following reason: The car/truck/motorcycle has been sold. The car/truck/motorcycle has been junked. I just purchased the car/truck/motorcycle and cannot obtain the title from the individual until the lien is paid off. The car/truck/motorcycle does not belong to me and I am unable to obtain the required proof from the owner. Other: Defendant: Date: Signature Sworn to and subscribed before me this day of , 20 . By: ______________________________ Deputy Clerk Office of Nikki Alvarez-Sowles, Esq. Pasco County Clerk & Comptroller AFFIDAVIT ACKNOWLEDGMENT The foregoing instrument was acknowledged before me this day of , 20 . by personally known to me (or who has produced as identification) and who did did not take an oath. NOTARY PUBLIC-STATE OF FLORIDA My commission expires: Commission No.: who appeared to me by physical presence by means of audio-video communication technology and
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Page 1 of 1 Affidavit of Non-Ownership Registration/InsuraneR 12/17/2020AFDV
IN THE COUNTY COURT FOR THE SIXTH JUDICIAL CIRCUIT IN AND FOR PASCO COUNTY, FLORIDA
STATE OF FLORIDA vs.
CITATION:
CASE:
AFFIDAVIT OF NON-OWNERSHIP REGISTRATION / INSURANCE
I, the undersigned, do hereby swear or affirm that under the penalty of perjury and possible contempt of court, that having been charged with:
No insurance
No tag/registration on the following vehicle:
Year: Make: Model: Color:
Do not have the required proof as required by statute and that I am unable to obtain this proof due to the following reason:
The car/truck/motorcycle has been sold.
The car/truck/motorcycle has been junked.
I just purchased the car/truck/motorcycle and cannot obtain the title from the individual until the lien is paid off.
The car/truck/motorcycle does not belong to me and I am unable to obtain the required proof from the owner.
Other:
Defendant: Date: Signature
Sworn to and subscribed before me this day of , 20 .
By: ______________________________ Deputy Clerk
Office of Nikki Alvarez-Sowles, Esq. Pasco County Clerk & Comptroller
AFFIDAVIT ACKNOWLEDGMENT The foregoing instrument was acknowledged before me this day of , 20 . by personally known to me (or who has produced as identification) and
who did did not take an oath.
NOTARY PUBLIC-STATE OF FLORIDA My commission expires: Commission No.:
who appeared to me by physical presence by means of audio-video communication technology and
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