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    This document is an affidavit form used to correct errors on a vehicle's certificate of title in Indiana. The form has sections for the seller to provide their name and the vehicle identification details. It then lists common errors that can be corrected, such as the odometer reading, date of sale, prices, or purchaser's name. The seller must sign and date the form to affirm the corrections, and that they are not making false statements.

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    This document is an affidavit form used to correct errors on a vehicle's certificate of title in Indiana. The form has sections for the seller to provide their name and the vehicle identification details. It then lists common errors that can be corrected, such as the odometer reading, date of sale, prices, or purchaser's name. The seller must sign and date the form to affirm the corrections, and that they are not making false statements.

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    certificate of title correction

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    55582 fill-in (1)

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    This document is an affidavit form used to correct errors on a vehicle's certificate of title in Indiana. The form has sections for the seller to provide their name and the vehicle identification details. It then lists common errors that can be corrected, such as the odometer reading, date of sale, prices, or purchaser's name. The seller must sign and date the form to affirm the corrections, and that they are not making false statements.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    116 views1 page

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    Uploaded by

    Rodney Cho Timbol
    This document is an affidavit form used to correct errors on a vehicle's certificate of title in Indiana. The form has sections for the seller to provide their name and the vehicle identification details. It then lists common errors that can be corrected, such as the odometer reading, date of sale, prices, or purchaser's name. The seller must sign and date the form to affirm the corrections, and that they are not making false statements.

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    AFFIDAVIT FOR CERTIFICATE OF TITLE CORRECTION


    State Form 55582 (R / 10-14)

    INDIANA BUREAU OF MOTOR VEHICLES

    INSTRUCTIONS:

    1. Complete in blue or black ink or print form. Copies may be accepted.


    2. Use the form below to correct information on a certificate of title or certificate
    of origin that contains errors, erasures or alterations. Illegible titles will not be accepted.
    SECTION 1. AFFIRMATION OF SELLER(S)

    Seller(s) Name (last, first, middle initial or company name)


    Certificate of Title Number (if applicable)

    Title Issue Date (mm/dd/yyyy)

    VEHICLE IDENTIFICATION NUMBER or HULL IDENTIFICATION NUMBER

    Year

    Make

    Model

    The following information was entered in error on the certificate of title or certificate or origin indicated above. I
    hereby request the Indiana Bureau of Motor Vehicles to correct this information upon application for certificate of
    title by the Purchaser.
    The Odometer Reading or Brand is incorrect.
    (A separate conforming odometer statement is required to be attached to this form.)
    The Date of Sale is incorrect. The correct Date of Sale is: ______________________ (mm/dd/yyyy).
    The Selling Price is incorrect.
    The Selling Price is:
    $__________.____

    The Trade in Price is incorrect.


    The Trade in Price is:
    $__________.____

    The Total Price Paid is incorrect.


    The Total Price Paid is:
    $__________.____

    The Name of Purchaser is incorrect and no other purchaser(s) have taken possession of this vehicle/watercraft other
    than the purchaser(s) indicated on this form. The Purchaser(s) is: _____________________________________________.
    Other: (Explain below.)

    I swear or affirm that the information entered on this form is true and correct. I understand that making a false
    statement may constitute the crime of perjury. I agree to indemnify and hold harmless the Indiana Bureau of Motor
    Vehicles from any liability arising from this transaction.
    Seller Signature

    Printed Name

    Date (mm/dd/yyyy)

    Seller Signature

    Printed Name

    Date (mm/dd/yyyy)

    The knowing or intentional failure of the seller or transferor to fill in all buyer information is a Class A misdemeanor or a
    Class D felony for the second or subsequent offense under IC 9-17-3-7(c) (2). (A Class A misdemeanor for the first
    violation; or a Class D felony for the second violation or any subsequent violation.)

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