ONE AND THE SAME CERTIFICATE

38-4306 R03/15 azdot.gov Clear

Vehicle Identification Number Year Make

Name On Document

Individual Name (first, middle, last, suffix) or Organization Name

I certify that the two names above are one and the same person, or one and the same organization.

Representative Name (if Organization Name above)

Signature

Notary or MVD Agent Signature

Acknowledged before me this date.

Date County State Commission Expires