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AFFIDAVIT OF FACTS TO ACCOMPANY INDEMNITY BOND

MVR-92H (Rev. 09/12) AFFIDAVIT OF FACTS TO ACCOMPANY INDEMNITY bond The following questions must be answered in detail and this form must be attached to any application for title that is supported by an INDEMNITY bond . Furnish any document in your possession showing proof of ownership. (Examples would be a Title, Bill of Sale, Conditional Sales Contract, Invoices, Out of State Registrations). Year Make Body Style Vehicle Identification Number 1. How did you acquire the vehicle? List the seller s full name, full address, and phone number. 2. List the date you acquired the vehicle. 3. Is the vehicle currently titled in North Carolina? If no, list the last title state. 4. Does the VIN plate appear on the vehicle? If so, please give the location. 5. Are there any liens outstanding on the vehicle?

MVR-92H (Rev. 09/12) AFFIDAVIT OF FACTS TO ACCOMPANY INDEMNITY BOND The following questions must be answered in detail and this form must be attached to any application for title that is supported by an Indemnity Bond.

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