Alaska Affidavit Of Homebuilt Trailer Form

Transcript

STATE OF ALASKA DIVISION OF MOTOR VEHICLES AFFIDAVIT OF HOMEBUILT TRAILER HMDE Year Built Make Body Style Color Name of Builder Approximate Weight Number of Axles Address City/State/Zip Name of Lienholder Address City/State/Zip Complete the lienholder information above, if there are any liens or encumbrances against this trailer. Where was the trailer built? Please provide the physical address. Where were the parts obtained for the following? Frame: Date: Body: Date: Has this trailer ever been registered? If yes, in what state? Yes ■ No Has this trailer ever been titled? If yes, in what state? Yes ■ No State: State: I hold the State of Alaska harmless and free from blame in any and all lawsuits concerning questions of title and ownership, and I promise to indemnify the State of Alaska and the Division of Motor Vehicles for any and all judgments against it arising out of these actions. I, , do hereby swear under penalty of law, the information contained in this affidavit is true, correct, and complete to the best of my knowledge and belief, and that all transactions were conducted in compliance with State laws. After printing, please check the information carefully. The form must be signed in front of a Notary or DMV employee. Signature of Builder Subscribed and Sworn To before me this day of Date , Notary or DMV Representative (AMVC & Office Number) My Commission Expires: 20 FOR DIVISION USE ONLY ALASKA VIN Form 819 (Rev. 07/09/2012) DATE Alaska.gov/dmv INITIALS Additional Information: • The person who built the trailer must complete the affidavit. • The vehicle must be inspected by a law enforcement officer or a representative of the Division of Motor Vehicles. • The trailer must be titled in the name of the builder before it can be sold. • DMV will issue a serial number (VIN) to the trailer. This number is to be permanently affixed to the tongue of the trailer. Items required: • Homebuilt Trailer Affidavit • Application for Title & Registration (812) • Fees Form 819 (Rev. 07/09/2012) Alaska.gov/dmv