Fillable Printable Motor Vehicle Power of Attorney - Florida

Motor Vehicle Power of Attorney - Florida

STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

DIVISION OF MOTOR VEHICLES

Neil Kirkman Building -Tallahassee, Florida 32399-0500

POWER OF ATTORNEY FOR A MOTOR VEHICLE, MOBILE HOME OR VESSEL

Date

I hereby name and appoint,

, to be my lawful attorney-

in-fact, to act for me, in applying for an original or duplicate certificate of title, to register, transfer

title, or record a lien to the motor vehicle, mobile home or vessel described below, and to print my

name and sign their name, in my behalf. My attorney-in-fact can also do all things necessary to

the application or any other related instrument and to bind me in as sufficient a manner as I myself

could do, were I personally present and signing the same.

With full power of substitution and revocation, I hereby ratify and confirm whatever my said

attorney-in-fact may lawfully do or cause to be done in the virtue hereof.

Motor Vehicle

CHECK ONE: Mobile Home Vessel

Make/Manufacturer

Identification Number

Year

Title Number

Model

Vessel Registration Number

Body

Wt.-Lgth.-BHP

NOTICE TO OWNER: COMPLETE THIS FORM IN ITS ENTIRETY PRIOR TO SIGNING.

Signature of Owner / Co-owner (Grantor)

Street Address of Owner / Co-owner (Grantor)

City

State

Zip

Date of Birth

Driver License Number

day of

Sworn to (or affirmed) and subscribed before me this

By:

(Name of Person Making Statement)

(Print, Type or Stamp Commissioned Name of Notary)

(SEAL)

(Signature of Notary)

Personally Known

or Produced Identification

Type of Identification Produced

Section 328.05, Florida Statutes, and Section 319.33, Florida Statutes, provides that whoever

knowingly makes a false statement in any application or affidavit required under the provisions of

such Chapter, or in a bill of sale or sworn statement of ownership, or otherwise commit a fraud in

any application, is guilty of a felony of the third degree, punishable as provided in s.775.082,

775.083, and 775.084.

If a power of attorney is used and the individual appointed as the attorney-in-fact will be

completing the odometer disclosure statement as the buyer only or the seller only, this non-secure

power of attorney form can be used. This form can not be used to allow an individual or entity to

sign as both buyer and seller confirming the Federal odometer reading. This may be

accomplished only with the secure power of attorney (HSMV 82995) when:

the title is physically being held by the lienholder; or

the title is lost

(a)

(b)

CAUTION: A seller cannot give a dealer or his employee a non-secure power of attorney (HSMV

82053) and have him or one of his employees sign a federal odometer statement, confirming the

mileage for both buyer and seller, as a dealer and his employees are considered a single entity.

(MERGED VVITH FORM HSMV 87005)

HSMV 82053 (Rev. 6199) S