Form Mv Irp-15 - Motor Vehicle Affidavit - 2010

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MV IRP-15

LABAMA

EPARTMENT OF

EVENUE

11/10

OTOR

EHICLE

IVISION

Motor Vehicle Affidavit

AFFIDAVIT OF NON-USE

I, the undersigned, hereby certify that I am the lawful and true owner of the vehicle described as:

(Year) ___________ (Make) _____________________________ (Vehicle Identification Number) ______________________________________________________.

I hereby certify under the penalties of perjury that this vehicle has not been used or operated on any public street, road or highway dur-

ing the license registration period:

____________________________________________________ through ____________________________________________________

DATE

I understand that Alabama law provides for an annual registration fee (license tax), collected on a staggered monthly basis for the use or

operation of this vehicle on public streets, roads and highways of this State and that this “Affidavit of Non-Use” will provide an exemption

from the penalty, if applicable, during the period cited above.

LEGAL RESIDENT AFFIDAVIT

I, the undersigned, swear under the penalty of perjury that I am a legal resident of Alabama and that my legal Alabama address is:

Address: ___________________________________________________________________________ County: ___________________________________________

City: _______________________________________________________________ State: __________________________________ Zip: ______________________

AFFIDAVIT

I, the undersigned, have knowledge of the following facts and as such am authorized to make this affidavit:

_____________________________________________________________________________________________________________________________________

I hereby certify that I have read the above and foregoing statement of facts and that said statements of facts are within my personal knowl-

edge and are true and correct in all respects. I further understand that said statements of facts are made under penalty of perjury.

I, hereby, certify under penalties of perjury that all information provided in affidavit(s) above are true and correct. I further understand that a false affirmation in the execu-

tion of a “Public Document” is a serious matter, in that Section 13A-10-102, Code of Alabama 1975 (as amended), provides that a false oath which misleads a public ser-

vant in the performance of his/her duty is a class A misdemeanor punishable by imprisonment for not more than one year and/or a fine of not more than $2,000.00. I also

understand that the official who accepts this affidavit, the State Revenue Department, State Examiners of Public Accounts or any other law enforcement agency of this

State may conduct a thorough investigation to determine the validity of this affidavit.

Owner’s Signature: _______________________________________________________________________ Driver License No.: __________________________________

I, hereby, certify that I identified the person who signed this affidavit and witnessed his/her signature on this the

__________ day of ________________________________________, __________.

Signature: _____________________________________________________________ Title: ______________________________________________________________

Note: This affidavit must be retained by the State or County Agency who accepts it for a period of no less than three (3) years.