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Vehicle & Damage Information
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Sworn Attestation
Client Signature
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Notary Acknowledgment
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STATE OF ARIZONA
On this _____ day of ________________, 20_____, before me personally appeared _______________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained.
Witness my hand and official seal.
Export Affidavit
Click below to download your signed affidavit PDF. Print, notarize, and submit with your DV demand package.