Fillable Printable Vehicle Power of Attorney State Form - Indiana

Vehicle Power of Attorney State Form - Indiana

POWER OF ATTORNEY - STATE OF INDIANA

State Form 1940 (R3/2-00)

PLEASE PRINT

I / We, ____________________________________________ , residing at ______________________________________________ in the county of

_________________________ do hereby appoint __________________________________________ as my/our attorney in fact to sign my/our name(s)

and complete information in relation to transactions involving the certificate of title or registration for the vehicle / watercraft as described below:

Make of vehicle / watercraft

Year

Vehicle or Hull I.D. number Title number

NOTE: In accordance with Indiana Code 30-5-4-1, all power-of-attorney forms must be notarized. Special deputies of the Bureau of Motor Vehicles may,

in lieu of a notary, sign power-of-attorney forms used in Indiana for Bureau of Motor Vehicles transactions. Special deputy verifications are valid only on

Bureau of Motor Vehicles documents in Indiana and are not recognized for interstate transactions.

(SEAL)

Special Deputy Bureau of Motor Vehicles, State of Indiana Chapter 01 Acts 1847

NOTE: Social Security / Federal ID

numbers are not required on power-

of-attorney form but are required for

title and registration applications.

Sworn to before me, a Notary Public, in and for said County, this __________ day of ________________________________ , 20 ____ .

Signature of Notary Public

Date commission expires

NOTARY CERTIFICATE

SS:

}

STATE OF

COUNTY OF

Printed or typed name of Notary Public

By:

Date (month, day, year)

Printed or typed name of owner

Signature of owner

Printed or typed name of ownerSignature of owner