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Get State Of Connecticut - Ct.gov - Ct

Ress of Lienholder) , do hereby swear that there was due from , of (Name of Debtor) the sum of $ (Address of Debtor) , secured by a valid lien dated , 20 on a motor vehicle described as follows: MAKE BODY STYLE MODEL IDENTIFICATION NO. YEAR MOTOR NO. And, I further swear that default having been made in the payment by said date, that the debtor voluntarily surrendered possession of said vehicle to the undersigned lienholder on , 20 , under accordance with the lien c.

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