New Hampshire Affidavit Of Repossession Form

Transcript

STATE OF NEW HAMPSHIRE DEPARTMENT OF SAFETY DIVISION OF MOTOR VEHICLES BUREAU OF TITLE AND ANTI-THEFT CONCORD, NH 03305 John J. Barthelmes Commissioner of Safety Director of Motor Vehicles AFFIDAVIT OF REPOSSESSION I NAME OF LIENHOLDER ADDRESS OF LIENHOLDER DO HEREBY SWEAR THAT THERE WAS DUE FROM: NAME OF DEBTOR ADDRESS OF DEBTOR THE SUM OF , SECURED BY A VALID LIEN DATED AS FOLLOWS: YEAR COLOR MAKE BODY TYPE YR. ON A MOTOR VEHICLE DESCRIBED V.I.N. AND, I FURTHER SWEAR THAT DEFAULT HAVING BEEN MADE IN THE PAYMENT BY SAID DATE, THAT THE DEBTOR VOLUNTARILY SURRENDERED POSSESSION OF SAID VEHICLE TO THE UNDERSIGNED LIENHOLDER ON: YR. (OR) I FURTHER SWEAR THAT DEFAULT HAVING BEEN MADE IN THE PAYMENT OF SAID DEBT, LIENHOLDER SEIZED SAID VEHICLE WITHOUT PROCESS OF LAW ON AUTHORITY OF THE CONDITIONS OF THE LIEN CONTRACT YR. UNDER YR. THE UNDERSIGNED LIENHOLDER HEREBY CERTIFIES THAT THE MOTOR VEHICLE DESCRIBED HEREIN WAS LAWFULLY REPOSSESSED UNDER THE TERMS OF A VALID AGREEMENT AND IN FULL ACCORD WITH THE PERTINENT SECTIONS OF THE NEW HAMPSHIRE REVISED STATUTES ANNOTATED. NAME OF LIENHOLDER TDMV 16 (Rev. 03/11) CORPORATION OFFICER, TRUSTEE, PARTNER