AFFIDAVIT OF FACT
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AFFIDAVIT OF FACT
This is to certify that an error was made on the following vehicle:
Year: _________ Make ____________ Model _________________
VIN #: ______________________________ TITLE #: __________________________
The erasure/alteration was made due to:
____ Name of purchaser was entered in error and has been corrected to show correct purchaser
_____________________________________________.
____ The names __________________________ and _________________________ shown on the
title identify one and the same person/business.
____ Seller signed Title to himself/herself in error, Title now stands corrected.
____ The odometer reading was entered in error on the above Title and has been corrected to read _____________ miles.
____ The date of sale on the above Title was entered in error and has been corrected to read ____________.
____ Seller signed name incorrectly and now stands corrected.
____ Seller signed on purchaser line in error.
____ Purchaser signed name incorrectly and now stands corrected.
____ Purchaser signed on seller line in error.
____ Other _______________________________________________________________________
_______________________________________________________________________
NO FRAUD INTENDED
___________________________ __________________________
Seller Signature Purchaser Signature
___________________________ __________________________
Seller Signature Purchaser Signature
________________ ________________
Date Date
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State of Texas
Walker County
WARNING: Transportation Code Section 501.155 provides that falsifying information on any required statement or application is a third-degree felony.
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