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Motor Vehicle Affidavit

  1. 62A044 (2-09)
    Commonwealth of Kentucky Department of Revenue
  2. Affidavit For Correction / Exoneration Of Motor Vehicle / Boat / Trailer Property Tax.
  3. kentucky-unbridled-spirit-logo-vector
  4. Vehicle sold in state (Code S)
  5. Enter year
  6. Vehicle sold out of state (Code s)
  7. Enter year
  8. Vehicle was in junkyard (Code J)
  9. Enter year
  10. Vehicle wrecked (Code J)
    Settled with insurance company
  11. Enter year
  12. Vehicle repossessed (Code N) by lien holder
  13. Enter year
  14. Non resident of Kentucky (Code N)
  15. Enter year
  16. Nonresident military (Code N)
    On January 1
  17. Statement showing another state as residency required
  18. Apportioned plate (Code N)
  19. Check one of the following
  20. Upload copy of proof
  21. High mileage according to guide
    On January 1
  22. Enter year
  23. Enter Mileage
  24. Damaged (physically or mechanically)
    Prior to January 1
  25. Enter year
  26. Upload description of the damage or related documentation
  27. Other
    Any other reason not already listed above
  28. *** Important ***
    I understand that if this vehicle/ boat has been junked and the tag and title have not been returned to the County Clerk office and I do not have these items in my possession that i must contact the clerks office.
  29. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  30. I hereby swear (affirm) under penalty of perjury that the information above is true and correct. I further attest that the property taxes on the above listed vehicle be corrected/ exonerated for the assessment date(s)
  31. Enter current year
  32. ***Important***
    It is now ordered, under the authority of the Kentucky Revised Statutes 133.110 and 133.130, that said error be corrected in accordance with the department of Revenue policy based on information listed above.
  33. Leave This Blank:

  34. This field is not part of the form submission.