Statement Of Existing Lease Agreement

STATEMENT OF EXISTING LEASE AGREEMENT State Form 12787 (R / 3-96) The following statement must be properly signed by both Lessor and Lessee, and presented to the Bureau of Motor Vehicles for title / registration of all leased motor vehicles. We ___________________________________________ Address _________________________________________________________________ are the owners of: Year ____________ Make _____________ Identification # _______________________________________________________ and have entered into a lease agreement with the following lessee: Lessee County Address THE PLATE FEE AND COUNTY EXCISE TAX ARE TO PAID BY THE: (Check one) LESSEE LESSOR, and will remain the property of the same. (If plate / excise ownership is different than indicated, an attached affidavit stating ownership is required.) THIS AFFIDAVIT HAS BEEN REVIEWED, AND IS BEING SIGNED UNDER PENALTY OF PERJURY . Signature of Owner / Lessor Date (month, day, year) By (Name) Position Signature of Lessee Date (month, day, year) STATEMENT OF EXISTING LEASE AGREEMENT State Form 12787 (R / 3-96) The following statement must be properly signed by both Lessor and Lessee, and presented to the Bureau of Motor Vehicles for title / registration of all leased motor vehicles. We ___________________________________________ Address _________________________________________________________________ are the owners of: Year ____________ Make _____________ Identification # _______________________________________________________ and have entered into a lease agreement with the following lessee: Lessee County Address THE PLATE FEE AND COUNTY EXCISE TAX ARE TO PAID BY THE: (Check one) LESSEE LESSOR, and will remain the property of the same. (If plate / excise ownership is different than indicated, an attached affidavit stating ownership is required.) THIS AFFIDAVIT HAS BEEN REVIEWED, AND IS BEING SIGNED UNDER PENALTY OF PERJURY . Signature of Owner / Lessor Date (month, day, year) By (Name) Position Signature of Lessee Date (month, day, year) American LegalNet, Inc. www.FormsWorkflow.com