STATE OF ALASKA
DIVISION OF MOTOR VEHICLES
SENIOR CITIZEN REGISTRATION EXEMPT AFFIDAVIT
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I, ____________________________________________________, am an Alaskan resident 65 years of age or older and
am applying for an exemption for one motor vehicle subject to registration. I am the registered owner, either solely or jointly, of the vehicle described above. I have no other vehicles registered with the senior citizen or the disability exemption per AS 28.10.411.
Date of Birth |
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If your address has changed please update.
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I have personally reviewed the information on this application and certify under penalty of perjury that to the best of my knowledge and belief the information on this application is true and correct.
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(SEAL) |
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Subscribed And Sworn To Before Me This |
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day of |
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, 20 |
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Notary or DMV Representative |
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Commission Expiration |
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Additional Information:
•Only one exemption is allowed per individual
Items required:
•Senior Citizen Registration Exempt Affidavit (807)
•A copy of the last registration issued, if available
If you do not live in an area with access to a DMV, you may mail the items to:
Submit to Alaska DMV:
Attn: Mailouts
1300 W. Benson Blvd., Suite 200
Anchorage, AK 99503
Phone: 907-269-5559
807 (Rev. 11/2014 ) |
www.alaska.gov/dmv/ |