Vehicle Identification Number
Year
Make
Plate Number
State
Applicant Name (first, middle, last, suffix)
Telephone
( )
Acquired From
Mailing Address
City
State
Supporting Documents
Owner Statement How did you acquire this vehicle/mobile home and why do you not have proper documentation? (explain fully all details)
If additional space is needed, use reverse side.
Applicant Signature
Acknowledged before me this date.
Notary or MVD Agent Signature
Date
County
State
Commission Expires
BONDED TITLE AFFIDAVIT
48-1302 R06/18
azdot.gov
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