State
of Wyoming Inspection and Certification of Correct "VIN"
Numbers
Application to County Clerk for:
Date
Issued ______________
Motor Vehicle Certificate of Title
Mobile Home Certificate of Title
Non-Resident, Non-Transferable Title Proof of Ownership must accompany application.
Make
Year
Vehicle
ID Number
Body
Style
Fuel
New
Used
Factory
Price
State
Prior
Title Number
Seller
Odometer
Purchase
Date
Owner's
Name _____________________________________
Owner's Address ___________________________________
City ______________ State_____ Zip _________
Seller's Name ______________________________________
Seller's Address ____________________________________
City ______________ State_____ Zip _________
Vehicle
subject to the following liens and no others...
Kind
Amount
Date
In
Favor of
Address
I
HEREBY SWEAR OR AFFIRM under penalty of perjury that all
information on this application for INSPECTION AND CERTIFICATION
OF CORRECT "VIN" NUMBERS AND/OR APPLICATION
FOR TITLE is true and correct and that I am lawfully applying
for a Wyoming Title. I further warrant that said vehicle
is owned by me (us) and is subject to the liens shown
and none other.
I
also certify to the best of my knowledge that if the
vehicle is a mobile home, all taxes due on the mobile
home for the preceding and current year have been paid
and in the event that taxes have not been paid, I acknowledge
that I/we may be responsible for the taxes due for the
preceding and current year.
Subscribed
and sworn to before me by ____________________________
(Signature
of Applicant)
this
__________________ day of _______________________ 20
______
County
Clerk, or Deputy County Clerk, or Notary_________________________________________
Affidavit
of Inspection and Certification of Correct "VIN"
Numbers
W.S.
31-3-102(b) provides a five dollar ($5.00) fee shall
be collected for each vehicle identification number
inspected pursuant to W.S. 31-2-103(a)(vi). The undersigned
being first duly sworn on solemn oath according to law,
and subject to penalties of perjury, deposes and says:
The
inspection occurred in Wyoming and was made by:
City Police Department
County Sheriff's Office
Highway Patrol
Make
____________________ Year ____________ VIN _________________________________
At
the request of the applicant for a Wyoming Certificate
of Title, I personally inspected the vehicle identification
number on the described vehicle and the information
entered by me is correct. (Please print)
Officer's
Name ________________________________ Badge
Number_______________________
Location
_____________________________________ Phone
Number_______________________ (Name
of Law Enforcement Agency)
Signature
____________________________________ Date
_______________________________
