Affidavit Without Proof of Compliance

IN THE COUNTY COURT, IN AND FOR SEMINOLE COUNTY, FLORIDA

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AFFIDAVIT WITHOUT PROOF OF COMPLIANCE

STATE OF FLORIDA COUNTY OF SEMINOLE:

COMES NOW, the undersigned and does hereby swear or affirm, subject to the penalty of perjury and possible contempt of court, that as of this date, he/she cannot provide a valid registration certificate/proof of security for reason(s) checked below and he/she files this Affidavit in compliance with the provisions of Section 318.18(2)(b)1.& 3., Florida Statutes (F.S.).

1. Vehicle was sold.
2. Vehicle was stolen or destroyed.
3. The owner registrant of the vehicle is not required by Section 627.733, F.S., to maintain personal injury protection insurance.
4. Vehicle is owned by another person.
5. State in which the vehicle is registered does not issue a certificate of registration.
6. Other (type below).

Other (If Chosen Above)

Type your full name into the signature field below to digitally sign this affidavit.

Defendant's Signature: /s*

Do you solemnly swear or affirm that the information contained within this affidavit is true and correct to the best of your knowledge?

Yes, I swear or affirm. *

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