STATE OF FLORIDA STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTOR VEHICLES DIVISION OF MOTOR VEHICLES
Neil Kirkman Building - Tallahassee, FL 32399 Neil Kirkman Building - Tallahassee, FL 32399

AFFIDAVIT FOR CHANGE/ALTERATION OF AFFIDAVIT FOR CHANGE/ALTERATION OF

BODY BODY
Date _____________________________________________________ Date _________________________________________, 20__________
This is to certify that ________________________________________ is This is to certify that ________________________________________ is
(Owner of Vehicle) (Owner of Vehicle)

the lawful owner of a _________________________________________. the lawful owner of a _________________________________________.

(Year) (Make) (Body Type) (Year) (Make) (Body Type)

Florida Title Number (if applicable) __________________________________ Florida Title Number (if applicable) __________________________________

Vehicle Identification Number ___________________________________ Vehicle Identification Number ___________________________________

Affiant further states that the _____________________________ Affiant further states that the _____________________________
(Body Type shown on MCO or Title) (Body Type shown on MCO or Title)

body has been removed from said vehicle (or the body has been altered) body has been removed from said vehicle (or the body has been altered)

and a __________________________________ body installed; and the and a __________________________________ body installed; and the
(Body Type Currently On Vehicle) (Body Type Currently On Vehicle)

Florida Title (as shown above) or the Manufacturer's Certificate of Origin Florida Title (as shown above) or the Manufacturer's Certificate of Origin

is herewith surrendered for correction/issuance, in order to properly is herewith surrendered for correction/issuance, in order to properly

identify the body type of the above described vehicle. identify the body type of the above described vehicle.
Current/Correct Weight of Vehicle _____________________________ Current/Correct Weight of Vehicle _____________________________
(Weight as shown on Weight Slip) (Weight as shown on Weight Slip)

Under penalties of Perjury, I Declare That I Have Read The Foregoing Under penalties of Perjury, I Declare That I Have Read The Foregoing
Document and That The Facts Stated In It Are True. Document and That The Facts Stated In It Are True.

_________________________________________ ____________________________ _________________________________________ ____________________________

(Signature of Owner) (Date) (Signature of Owner) (Date)
HSMV 82100 (Rev. 5/01) HSMV 82100 (Rev. 5/01)