Transcription of AFFIDAVIT OF VEHICLE PURCHASE PRICE - Virginia
1 Purpose: Use this form to certify the PURCHASE PRICE of a motor VEHICLE 5 years old or less in order to obtain a title for that VEHICLE . NOTE: Do not use this form for vehicles more than 5 years old, use a VEHICLE PRICE Certification form (SUT 1) or a bill of sale. Instructions: Complete the form, have it notarized and submit it with other titling (must be completed by notary public)MY COMMISSION EXPIRES (mm/dd/yyyy) REGISTRATION NUMBER NOTARY PUBLIC NAME NOTARY PUBLIC SIGNATURES tate/Commonwealth of _____, city or county of _____ subscribed and sworn to before me on this _____ day of _____ (MONTH) (YEAR) by_____ in the city or county and state aforesaid. NOTARY PUBLIC SEALIn accordance with all applicable statutes, administrative rules and regulations I certify that the PURCHASE PRICE of the above-described motor VEHICLE was $ _____, which included all accessories and/or attachments with no trade-in allowance or any other transaction.
2 I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal NAME (print)DATE (mm/dd/yyyy)CO-SIGNER SIGNATURE CO-SIGNER NAME (print)DATE (mm/dd/yyyy)APPLICANT SIGNATURE AFFIDAVIT OF VEHICLE PURCHASE PRICE ( VEHICLE MUST BE 5 YEARS OLD OR LESS) SUT 1A (08/10/2017) VEHICLE INFORMATION SALE DATE (mm/dd/yyyy) VEHICLE IDENTIFICATION NUMBER (VIN)COLORYEAR (5 years old or less)MAKEMODELBODY TYPE
