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South Dakota General Purpose Affidavit for Vehicle/Boat Registration Form

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South Dakota General Purpose Affidavit for Vehicle/Boat Registration Form
South Dakota General Purpose Affidavit for Vehicle/Boat Registration Form
SOUTH DAKOTA DIVISION OF MOTOR VEHICLES
GENERAL PURPOSE AFFIDAVIT FOR VEHICLE/BOAT REGISTRATION
AFFIANT NAME(S)________________________________ ADDRESS _______________________________________
________________________________ ADDRESS _______________________________________
VEHICLE/BOAT DATA YEAR______ MAKE______ SERIAL # ____________________________________________
LICENSE # ______________________ STATE______ TITLE #___________________ TITLED IN (STATE) _________
I (We) hereby affirm under oath that I (we) purchased the above described vehicle/boat on _____________ (date) from
_________________________ and that a bill of sale, Manufacturer's Statement of Origin (MSO), or other documentation
of ownership is not available for presentation with the attached title application for the reasons stated in the Statement of
Fact below. I (We) declare that the above noted party was the sole owner of this vehicle/boat and that they have declared
it to be free and clear of all liens and encumbrances.
OR
(The following Statement of Fact is to be used to disclose any other information for which an affidavit is required.)
STATEMENT OF FACT
I (We) hereby request that the Department of Revenue issue Title covering this vehicle/boat in my (our) name(s), and
that I (we) agree to protect and indemnify the South Dakota Department of Revenue, Division of Motor Vehicles, against
any and all liabilities and claims which may arise as a result of this title issuance.
Signature of Affiant(s)____________________________ __________________________________________________
STATE OF SOUTH DAKOTA
COUNTY OF ______________________________ SS.
Subscribed and Sworn to before me this ____________
day of _________________________________,20____
____________________________________________
Notary Public or County Treasurer
____________________________________________
Date Commission Expires
DOR-MV215(03-02)
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SD EForm -
0858
1.
South Dakota General Purpose Affidavit for Vehicle/Boat Registration Form