IGS - Affidavit Of Non-Ownership/Non-Liability

AFFIDAVIT OF NON-OWNERSHIP or AFFIDAVIT OF NON-LIABILITY
The registered owner of a vehicle is responsible for parking violations, and at the time of the issuance of this citation, DMV records indicate that you are the current owner. If you did not own this vehicle at the time the citation was issued, you must return a certified copy of the "Release of Liability" form that you filed with the DMV, changing the ownership over to whomever you sold or gave the vehicle to. Sign and return this form with the DMV form to the address listed below.

Collections Division

950 Maidu Ave, Ste. 129

PO Box 599002

Nevada City, CA 95959

Telephone (530) 265-1238

Fax (530) 265-7112

If the vehicle was leased or rented, proof of the written lease or rental agreement must be delivered to the Collections Division with a completed affidavit.
Citation #
Vehicle License Number
I was not the owner, renter, or lessee of the motor vehicle described, per attached form from DMV and the information supplied below.
Name of Purchaser Lessee or Renter
Address

Street Address

Street Address Line 2

CityState

Zip Code
Date of Purchase Sale or Lease

MonthDayYear
I declare under penalty of perjury, under the laws of the State of California, that the forgoing is true and correct. (Penal Code $118;129;131)
Signature

Signature*
Name
Date

MonthDayYear
Should be Empty:

AFFIDAVIT OF NON-OWNERSHIP or AFFIDAVIT OF NON-LIABILITY