of perjury, that all information on this Affidavit is

							                 WASHAKIE COUNTY AFFIDAVIT OF OWNERSHIP


Make - - - - - - - - Year - - - - - - - - Odometer
- - - - - -

VIN/HIN                                                                Hull Material            _


Vessel Length                  Vessel Type               Fuel Type            _


Model                   _    Factory Cost                 _


Previous Title Number (if known)                               _

====~==================================================



Name of Owner(s)                                                                       _
(As will appear on Title)

Address - - - - - - - - - - - - - - - - - - - - - -

        City                            State             Zip Code                          _
===============~=============================~===========

Previous owner's name if known
- - - - - - - - - - - -
Address/City/State                                                                              _


Explain why you were unable to obtain title




I do hereby certify under penalty of perjury, that all information on this Affidavit is true

and correct, I am the true and lawful owner of the vehicle/watercraft described herein,

and I further attest that the liens and encumbrances noted hereon are the only liens and

encumbrances against the vehicle described herein.

Amount of Lien:                   Lender:                                    _


Applicant Printed Name:                                         _


Applicant Signature:                                                 Date:             _



The foregoing instrument was acknowledged before me by                                          this

___ day of                                 _


Witness my hand and official seal



Notary/ County Clerk! Deputy County Clerk