STATE OF ALASKA DIVISION OF MOTOR VEHICLES
AFFIDAVIT OF REPOSSESSION
License Plate Number
Year
Make
Registered Owner(s)
State
Serial Number (VIN)
Model
Body Style
Color
Address
City/State/Zip
Lienholder
Address
City/State/Zip
I certify under penalty of state and/or federal law that: •
I am the lienholder, or agent of the lienholder, recorded on the records of the Alaska Division of Motor Vehicles.
•
The above referenced vehicle was repossessed on
•
Full compliance with Alaska Statutes 45.29.601 - 45.29.628 governing foreclosure proceeding has been met.
•
The vehicle: (Check one) Is currently in my/our possession.
.
Use an "X" to select your choice.
Was sold to the person or company indicated in the bill of sale provided below.
Printed Name of Lienholder
Signature of Lienholder or Authorized Agent
Subscribed and Sworn to before me this day of
(SEAL) ,
20
Signature of Notary or DMV Representative (AMVC & Office Location) My Commission Expires:
Check form carefully after printing. Must be signed in front of a notary or DMV employee.
BILL OF SALE On
the vehicle referenced above was sold to Date
Name
The odometer now reads (no tenths) miles and to the best of my knowledge it reflects the actual mileage of the vehicle unless one of the following statements is checked: The odometer reading reflects the amount of mileage in excess of the mechanical limits. The odometer reading is NOT the actual mileage. WARNING . . . ODOMETER DISCREPANCY.
Signature of Lienholder or Authorized Agent
Signature of Buyer
Printed Name of Lienholder or Authorized Agent
Printed Name of Buyer
NOTE: This form can only be used for vehicles titled in Alaska. Form 843 (Rev. 10/2009)
Alaska.gov/dmv
Additional Information: The lienholder or subsequent buyer named on the Affidavit of Repossession must title the vehicle in their name before it can be sold. Title requirements: • • •
Application for Title & Registration (Form 812) Notarized Affidavit of Repossession (Form 843) Original title OR a notarized Affidavit of Lost Title (Form 809) IF A LIEN HAS NOT BEEN RECORDED ON DMV RECORDS, AN AFFIDAVIT OF REPOSSESSION IS NOT VALID FOR OBTAINING A TITLE TRANSFER.