Transcript
AFFIDAVIT OF INCOMPLETE TRANSFER I,
, I hereby certify that on or about , 20
vehicle, year
, I transferred my interest in the following described
, make
, and vehicle identification number to
by executing an assignment and warranty of title to the transferee in the space provided therefore on the Certificate of Title, and/or executing the applicable portions of the vehicle transaction record (TC-96-182) as provided by KRS 186A.215(1). I request further registration on this vehicle be restricted as provided by law until this transfer has been processed.
Subscribed and sworn to before me this day of , 20
Signature of Owner(s)
Signature Address Title My Commision Expires
City, State, Zip Code Owner’s SSN
KRS 186A.215(4) If it comes to the attention of a transferor that a transferee did not promptly submit the necessary document within fifteen (15) calendar days to the county clerk as required by law in order to complete the transfer transaction, a transferor shall submit to the county clerk, in his county of residence, an affidavit that he has transferred his interest in a specific vehicle and the clerk shall enter appropriate data into the AVIS system which shall restrict any registration transaction from occurring on that vehicle until the transfer has been processed.
