Blank Affidavit of Vehicle Tax

---

State of _______________
County of _______________

Before me, the undersigned authority, on this day personally appeared _______________, who, being by me duly sworn, deposed and stated as follows:

1. Affiant Information:

   • Full Legal Name: _______________

   • Address: _______________

   • Contact Number: _______________

2. Vehicle Information:

   • Make: _______________

   • Model: _______________

   • Year: _______________

   • VIN (Vehicle Identification Number): _______________

3. Statement of Tax:

   • I, _________________________, certify that the vehicle described above has: _______________

4. Purpose of Affidavit:

   • This affidavit is being executed for the purpose of: _______________

5. Declaration:

   • I affirm that the above information is true and correct to the best of my knowledge and belief. I understand that providing false information in this affidavit may result in penalties under the law.

Signature of Affiant:

---

[ _______________]

Date: _______________

---

Notary Public:

Subscribed and sworn to before me this ___ day of _______, 20 by _______________, who is personally known to me or who has produced _______________ as identification.

---

Notary Public, State of _______________

My Commission Expires: _______________

Affidavit Templates @ Template.net