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Mississippi Tax Lien Laws

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					MISSISSIPPI STATE TAX COMISSION
TITLE DIVISION
FORM 65-022 / REV. 4/89
SUPERSEDES PREVIOUS
REVISIONS OF THIS FORM

                                                            AFFIDAVIT OF SALE UNDER LIEN
                                                CERTIFICATE OF TITLE MUST ACCOMPANY THIS DOCUMENT

THE STATE OF MISSISSIPPI, COUNTY _____________________________, DATE _________________________
_______________________________ OR ________________________________OR _____________________________
           (Name of Lienholder)                                 (Pres., V.Pres., Sec-Treas.)                                    (Manager)
OF ______________________________________, make oath in due form of law that the undersigned was the lawful owner
          (Name of lienholder if corporation or partnership)
and holder of an indeptedness owed by ___________________________________________________________________
                                                                                  (Name of Person Owing Idebtedness)
of ______________________________________________ secured by lien on Motor Vehicle described in certificate of
                                      (Address)

Title Number _____________________________, Vehicle Identification Number __________________________________

Default having been made, the undersigned foreclosed the lien in the manner provided by law and by the terms of the lien

instrument and sold the vehicle described to _______________________________________________________________
                                                                                                    (Name of Buyer)
_________________________________ on ___________________________ at _________________________________
                  (Address)                                              (Date)                                          (Place of Sale)

for $________________________.
                (Consideration)
The undersigned states that all applicable laws of the State of Mississippi, as well as the applicable laws of any other state
where the Vehicle may have been repossessed, have been fully complied with, and the undersigned further states and
guarantees that the purchaser has good Title to the Vehicle which is warranted subject to the following liens:

________________________________, __________________________________, _______________________________

AND AFFIANT FURTHER STATES;

Federal law and State law requires that you state the mileage in connection with the transfer of ownership. Failure to
complete or providing a false statement may result in fines and/or imprisonment.

I, _____________________________________________, state that the odometer now reads ___________(NO TENTHS) miles and to the
best of my knowledge that it reflects the actual mileage of the vehicle described herein, unless one of the following statements is checked:

________ (1) I hereby certify to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits.


________ (2) I hereby certify that the odometer reading is NOT the actual mileage. WARNING – ODOMETER DISCREPANCY




     Printed Name of Seller (Same as Appears in Title)                                                     Printed Name of Buyer (As Shown Above)



                         Signature                                                                                         Signature



                       Printed Name                                                                                      Printed Name

SWORN TO AND SUBSCRIBED BEFORE ME

AT ____________________________________________ this _______________ day of __________________, 20 ______

_______________________________________________                                         SEAL
                                          (Notary Public)

				
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