STATE OF FLORIDA

IN THE COUNTY COURT OF THE

NINTH JUDICIAL CIRCUIT IN AND
FOR ORANGE COUNTY, FLORIDA
VS.
 
Case No:

 
 
 
AFFIDAVIT OF NON-OWNERSHIP
 
Before me, personally appeared, the above named Defendant who having been duly sworn,
deposes and says:
 
My name is . I reside permanently at
. I received the above numbered complaint charging me with
on .
 
 
I cannot provide a copy of a valid registration/proof of insurance for the vehicle cited. The reason
I cannot provide a copy of the valid registration/proof of insurance is because I do not own the
vehicle.
 
 
 
 
 
 
Sworn and Subscribed before me on
File Date: day of ,
 
 
Signature of Defendant Deputy Clerk/Notary