POWER OF ATTORNEY TO SIGN FOR OWNER
WHEN REGISTERING AND/OR TRANSFERRING OWNERSHIP OF A MOTOR VEHICLE
VSA 70 (05/10/2018)
VEHICLE OWNER(S):
OWNER NAME (last, first, middle)
VEHICLE INFORMATION
VEHICLE MAKE
BODY TYPE
MODEL YEAR VEHICLE IDENTIFICATION NUMBER (VIN) TITLE NUMBER
CERTIFICATION
OWNER SIGNATURE CO-OWNER SIGNATURE
DMV CUSTOMER NUMBER/EMPLOYER FEDERAL ID
NUMBER (If vehicle owned by a company or corporation)
DATE
(mm/dd/yyyy)
DMV CUSTOMER NUMBER/EMPLOYER FEDERAL
ID NUMBER (If vehicle owned by a company or corporation)
DATE
(mm/dd/yyyy)
CO-OWNER NAME (last, first, middle)
CO-OWNER STREET ADDRESSOWNER STREET ADDRESS
CITY STATE ZIP
CITY STATE ZIP
POWER OF ATTORNEY GRANTED TO:
FULL LEGAL NAME (last) (first) (middle) (suffix)
STREET ADDRESS
CITY STATE ZIP
I/We, being the owner(s) of the motor vehicle described above, by these presents do make, constitute, and appoint the person named above true and lawful
attorney-in-fact to sign in my/our name, place, and stead any Certificate of Title, or other supporting papers, covering said motor vehicle, in whatever manner
necessary to register and/or transfer ownership of said motor vehicle; and I/we do hereby grant unto said attorney-in fact full authority and power to do and
perform any and all other acts necessary or incidents to the execution of the powers herein expressly granted, as the grantor might or could do if personally
present, with full power of substitution.
I/We further certify and affirm that all information presented in this form is true and correct, that any documents I/we have presented to DMV are genuine, and
that the information included in all supporting documentation is true and accurate. I/We make this certification and affirmation under penalty of perjury and I/we
understand that knowingly making a false statement or representation on this form is a criminal violation.
