AFFIDAVIT OF NON-OWNERSHIP
STATE OF FLORIDA
COUNTY OF
COMES NOW __________________________, who, after being first duly
sworn by me, deposes and says as follows:
1) That my name is ___________________________________, and I reside
at ____________________________________________________________________.
2) That, on ___________________________, I did not own an operable
motor vehicle subject to the Florida No Fault law.
Further Affiant sayeth not.
____________________________
Affiant
The foregoing Affidavit was acknowledged before me this _____ day of
______________, 2013 by ________________________________, □ who is personally
known to me or □ who produced ID / DL #_________________________________ as
identification.
______________________________
NOTARY PUBLIC,
STATE OF FLORIDA
(SEAL/STAMP)
