797-R-05-97

AFFIDAVIT OF NONUSE IN LIEU OF LIABILITY INSURANCE

 

State of Oklahoma,______________________________§:
County of ______________________________________§:

The undersigned affiant being first duty sworn upon his/her oath states and certifies that he/she is the owner of the motor
vehicle with description of record as follows, to wit:

_______________________________________________________________________________________________
 YEAR MADE           MAKE            TYPE                                 SERIAL NUMBER                                                    TAG NUMBER

________________________________________________________________________________
OWNER                       ADDRESS                                           CITY/STATE/ZIP

That the vehicle described above will not be driven on Oklahoma public streets or public highways
from (date)_______________________to (date)_______________________due to____________________________
and is, therefore, exempt from the provisions of Section 7-601 et seq. of Title 47 of the Oklahoma Statutes. Upon any
change in status, the owner will execute the proper affidavit of insurance required by law.

 

NOTICE: SECTION 7-610 OF TITLE 47 OF THE OKLAHOMA STATUTES REQUIRES THE DEPARTMENT OF PUBLIC SAFETY
TO CONTACT YOU FOR WRITTEN VERIFICATION CONCERNING THIS DECLARATION.

Under the above provisions, the owner hereby makes application for 20______registration for the above mentioned vehicle.

_______________________________________________________________________________________________
 DRIVER LICENSE NUMBER                                                                                                             RECORD OWNER SIGNATURE

Subscribed and sworn to before me this_________________day of ________________________, 20____.

My commission expires:_____________________________________________.                     _______________________________________,Notary Public