Title Release Affidavit Form

TITLE RELEASE AFFIDAVIT FORM

This Title Release Affidavit is executed on Date: by Affiant Name: whose Address: and Recipient Name: whose Address: (collectively, the Parties).

RECITALS

WHEREAS, Affiant represents that Affiant is the lawful owner of the motor vehicle described below and holds title to that motor vehicle subject to the lien, encumbrance or claim described in Section 4; and

WHEREAS, the Parties desire to document the release of title or lien so that the title may be transferred, reissued, or otherwise cleared of the described encumbrance and so that the Recipient may record or rely upon this affidavit in dealing with title records, transfer, registration, or related matters.

WHEREAS, Affiant affirms under penalty of perjury the truthfulness of the statements set forth herein and acknowledges that false statements may be subject to civil and criminal penalties.

NOW, THEREFORE

In consideration of the foregoing recitals and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows.

1. VEHICLE IDENTIFICATION

Year:   Make:   Model:   VIN:

License Plate No.:

2. AFFIANT REPRESENTATIONS AND WARRANTY

Affiant represents, warrants and certifies that Affiant is the lawful owner of the vehicle described in Section 1, that Affiant has full authority to execute this affidavit, and that, except as disclosed in Section 4, the vehicle is free and clear of all liens, security interests, and encumbrances.

Affiant further represents that Affiant's name appears on the current title document as Owner Name: and that Affiant's government-issued identification number is Driver's License/ID Number: Issuing State:

3. LIEN, ENCUMBRANCE OR RELEASE DETAILS

Lienholder Name:

Account/Reference Number:

The lien described above was satisfied, released or otherwise resolved on: Day:   Month:   Year:

Nature of release (select applicable): Paid in full   Repossessed/returned   Other

4. AFFIDAVIT AND RELEASE

Affiant affirms that, to Affiant's best knowledge and belief, the lien or encumbrance described in Section 3 has been satisfied, released, or otherwise extinguished as of the date provided above. Affiant hereby authorizes and requests that the Recipient, any title-issuing authority, and any recording entity accept this affidavit as evidence of release of the described lien or encumbrance.

Affiant covenants to deliver any original lien release, satisfaction instrument, bill of sale, or title endorsement in Affiant's possession to the Recipient within a reasonable time and to cooperate in the execution of any further instruments reasonably necessary to effectuate the release or transfer of title.

5. INDEMNIFICATION

Affiant agrees to indemnify, defend and hold harmless the Recipient from and against any losses, costs, liabilities, claims, or expenses (including reasonable attorneys' fees) arising out of any breach of the representations in this affidavit or from the existence of undisclosed liens or encumbrances affecting the vehicle.

6. NOTICES

All notices or other communications required or permitted under this affidavit shall be in writing and delivered to the addresses set forth in the opening paragraph or to any subsequent address provided in writing by a Party to the other Party.

7. GOVERNING LAW; VENUE

This affidavit shall be governed by and construed in accordance with the laws of the state specified by the Parties. The Parties agree that any dispute arising out of or relating to this affidavit shall be subject to the exclusive jurisdiction and venue of the competent courts of that state.

8. ENTIRE AGREEMENT; SEVERABILITY; AMENDMENT

This affidavit constitutes the entire agreement between the Parties with respect to the subject matter herein and supersedes all prior agreements and understandings, whether written or oral. If any provision of this affidavit is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. This affidavit may be amended only by a written instrument executed by both Parties.

9. COUNTERPARTS; ELECTRONIC SIGNATURES

This affidavit may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. Signatures transmitted by electronic means shall be deemed originals for all purposes.

The undersigned Affiant certifies under penalty of perjury under the laws of the applicable jurisdiction that the information contained in this affidavit is true and correct and that Affiant is competent to execute this affidavit and to bind Affiant to its terms.

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