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North Carolina Division of Motor Vehicles AFFIDAVIT OF ...

Seller/s_____(NAME/S AND ADDRESS)This will certify that I/we did not sell or deliver a _____(YEAR)(MAKE)(BODY STYLE)_____to _____ .(VEHICLE IDENTIFICATION NUMBER)(PURCHASER/S)I/we did sell and deliver a _____(YEAR)(MAKE)(BODY STYLE)(VEHICLE IDENTIFICATION NUMBER)The incorrect manufacturer s certificate of origin or the incorrect certificate of title number _____ was (SIGNATURE/S OF SELLER/S)By: _____(AUTHORIZED REPRESENTATIVE)Date _____County _____State_____I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarilysigned the foregoing document for the purpose stated therein and in the capacity indicated.

North Carolina Division of Motor Vehicles AFFIDAVIT OF FACTS SURROUNDING THE INCORRECT ASSIGNMENT OF A MANUFACTURER’S CERTIFICATE OF ORIGIN OR A CERTIFICATE OF TITLE MVR-28 (Rev. 1/06) 1 2 3. Title: MVR-28 Author: North Carolina DMV Subject: VR Keywords: AFFIDAVIT OF FACTS SURROUNDING THE INCORRECT …

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