Form H-125 "Affidavit of Motor Vehicle Transfer by Self-service Storage Facility" - Connecticut

What Is Form H-125?

This is a legal form that was released by the Connecticut Department of Motor Vehicles - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Connecticut Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form H-125 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Motor Vehicles.

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Download Form H-125 "Affidavit of Motor Vehicle Transfer by Self-service Storage Facility" - Connecticut

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AFFIDAVIT OF MOTOR VEHICLE TRANSFER BY
SELF-SERVICE STORAGE FACILITY
H-125 REV. 3-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
60 STATE STREET, WETHERSFIELD, CT 06161
DEALERS AND REPAIRERS SECTION
On The Web at ct.gov/dmv
The Undersigned, being duly sworn, deposes and says:
1. I am the owner and/or operator of
______________________________
, a self-service storage
(Name of Business)
facility that is required to comply with sections 42-159 through 42-168 of the Connecticut General Statutes. I am
authorized to act on behalf of the named business.
2. On
_______________
, I filed a notice of intent to transfer the motor vehicle described herein that was left on
(date)
the business premises by
_____________________________
, who was in default on rental payments for
(occupant name)
a period of at least 60 days.
YEAR
VEHICLE IDENTIFICATION NUMBER
MAKE
MODEL
MOTOR VEHICLE OWNER(S) (NAME AND ADDRESS)
LIENHOLDER(S) ON DMV RECORDS (NAME AND ADDRESS)
3. I sent a notice of default to the occupant that complies with section 42-162 of the Connecticut General Statutes by
certified or registered mail, return receipt requested.
4. I sent a notice that complies with section 42-160 of the Connecticut General Statutes, by certified or registered mail,
return receipt requested, to the motor vehicle owner(s) (if other than the occupant) and the lienholder(s) named herein.
5. The vehicle described herein was sold at a public sale on
__________________
at
________________
(date)
(location)
and was sold to
__________________________________________
(purchaser(s)). The sale was advertised on
____________
and
_____________
in
__________________________
commencing at least ten
(dates)
(newspaper(s))
days before the sale. (Proof must be attached.)s) (if other than the occupant) and the lienholder(s) named herein.
6. The motor vehicle owner(s) (if not the occupant) and the lienholder(s) named herein were notified of the date, time
and place of the sale by certified or registered mail, return receipt requested. (Proof must be attached.)
7. I have satisfied the lien(s) in the records of the Department of Motor Vehicles, and submit the following
documentation/information relative to the satisfaction of the lien(s):
8. I have furnished this original affidavit to the purchaser of the motor vehicle or the purchaser’s agent, along with
the following documents:
* Bill of sale
* Copies of at least two newspaper publications and the dates of publication (commencing at least
ten days before sale) - See paragraph 5
* Copies of notification to motor vehicle owner (if not occupant) and lienholder of date, time and
place of the sale, and copies of return receipts for mailing the notification - See paragraph 6
The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned, under penalty of
false statement, in accordance with Sections 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make
a statement which I do not believe to be true with the intent to mislead the Commissioner, I will be subject to prosecution under
the above-cited laws.
Signature:
Date:
State of CONNECTICUT
County of
20
at
, Connecticut
Subscribed and sworn to before me this
day of
X
Notary Public/Commissioner of the Superior Court
(If Notary, commission expiration date)
AFFIDAVIT OF MOTOR VEHICLE TRANSFER BY
SELF-SERVICE STORAGE FACILITY
H-125 REV. 3-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
60 STATE STREET, WETHERSFIELD, CT 06161
DEALERS AND REPAIRERS SECTION
On The Web at ct.gov/dmv
The Undersigned, being duly sworn, deposes and says:
1. I am the owner and/or operator of
______________________________
, a self-service storage
(Name of Business)
facility that is required to comply with sections 42-159 through 42-168 of the Connecticut General Statutes. I am
authorized to act on behalf of the named business.
2. On
_______________
, I filed a notice of intent to transfer the motor vehicle described herein that was left on
(date)
the business premises by
_____________________________
, who was in default on rental payments for
(occupant name)
a period of at least 60 days.
YEAR
VEHICLE IDENTIFICATION NUMBER
MAKE
MODEL
MOTOR VEHICLE OWNER(S) (NAME AND ADDRESS)
LIENHOLDER(S) ON DMV RECORDS (NAME AND ADDRESS)
3. I sent a notice of default to the occupant that complies with section 42-162 of the Connecticut General Statutes by
certified or registered mail, return receipt requested.
4. I sent a notice that complies with section 42-160 of the Connecticut General Statutes, by certified or registered mail,
return receipt requested, to the motor vehicle owner(s) (if other than the occupant) and the lienholder(s) named herein.
5. The vehicle described herein was sold at a public sale on
__________________
at
________________
(date)
(location)
and was sold to
__________________________________________
(purchaser(s)). The sale was advertised on
____________
and
_____________
in
__________________________
commencing at least ten
(dates)
(newspaper(s))
days before the sale. (Proof must be attached.)s) (if other than the occupant) and the lienholder(s) named herein.
6. The motor vehicle owner(s) (if not the occupant) and the lienholder(s) named herein were notified of the date, time
and place of the sale by certified or registered mail, return receipt requested. (Proof must be attached.)
7. I have satisfied the lien(s) in the records of the Department of Motor Vehicles, and submit the following
documentation/information relative to the satisfaction of the lien(s):
8. I have furnished this original affidavit to the purchaser of the motor vehicle or the purchaser’s agent, along with
the following documents:
* Bill of sale
* Copies of at least two newspaper publications and the dates of publication (commencing at least
ten days before sale) - See paragraph 5
* Copies of notification to motor vehicle owner (if not occupant) and lienholder of date, time and
place of the sale, and copies of return receipts for mailing the notification - See paragraph 6
The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned, under penalty of
false statement, in accordance with Sections 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make
a statement which I do not believe to be true with the intent to mislead the Commissioner, I will be subject to prosecution under
the above-cited laws.
Signature:
Date:
State of CONNECTICUT
County of
20
at
, Connecticut
Subscribed and sworn to before me this
day of
X
Notary Public/Commissioner of the Superior Court
(If Notary, commission expiration date)