Affidavit of Ownership by Repossession
Affidavit of Ownership by Repossession
Affidavit of Ownership by Repossession
OWNERSHIP BY REPOSSESSION
This form is for Nebraska lienholders only. Out-of-state
lienholders must use a form approved by their state of
residence.
1. the debtor has defaulted in connection with an obligation secured by the vehicle/boat
specified above;
2. we have exercised our post-default remedies with respect to this collateral;
3. by reason of this exercise, we are acquiring the rights of the debtor in this collateral.
Repossessed from
Name of Debtor
Affiant swears that he/she is making this statement for the purpose of having the designated County
Official issue a Certificate of Title in his/her name as indicated by the attached Application for Certificate
of Title.
Affiant swears that he/she will warrant and defend the title and rights of this motor vehicle and protect the
issuing designated County Official from any damages that might arise from irregularities on same.
Notary Public
Seal
The lien shall not be released on the face of the title accompanying this Affidavit.
The date of Transfer of Ownership recorded above must be equal to or less than the notary date.
The date of Transfer of Ownership will be used as the purchase date on the Certificate of Title
issued pursuant to this Affidavit.
Revised 9/2020