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									                                AFFIDAVIT OF FACT

STATE OF TEXAS
JEFFERSON COUNTY


TO WHOM IT MAY CONCERN:

This is to certify that an error was made on the following vehicle:

Year_________________              Make_____________________________________
VIN Number:__________________________________________________________
Title Number:_______________________________________________________________
Typographical error in Assignment of Title
     ●    Title Assigned in error to ________________________________________
     ●    The correct Purchaser is _________________________________________

Odometer reading was altered in error

     ●    The correct reading is ___________________________________________

Date of Sale

     ●    This is to certify that the vehicle was sold on _________________________.

This is to certify that _________________________ and ________________________
are one and the same.


Other _______________________________________________________________________

     _______________________________________________________________________

NO FRAUD INTENDED                               _________________________________


                                        DATE: _________________________________

WARNING:       TEXAS TRANSPORTATION CODE '502.410 PROVIDES THAT
               FALSIFYING INFORMATION ON ANY REQUIRED STATEMENT OR
               APPLICATION IS A THIRD-DEGREE FELONY.

								
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