2.4394 3.0549 Td Make use of the Sign Tool to add and create your electronic signature to certify the Affidavit form of correction. Let's take a few moments to recap what we've learned. /ZaDb 7.2827 Tf '| !G q '| !G endstream endobj 58 0 obj <>/Metadata 3 0 R/Pages 55 0 R/StructTreeRoot 9 0 R/Type/Catalog>> endobj 59 0 obj <>/MediaBox[0 0 612 792]/Parent 55 0 R/Resources<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/W/Type/Page>> endobj 60 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream W Check statement that applies: 1. (4) Tj /Tx BMC This affidavit addresses the following errors that were not performed in accordance with 49 CFR Part 40, as amended: Step 1 Requirements (§40.63) ___ A. Missing/Incorrect Employer Name, Address (check all that apply) ___ B. Missing/Incorrect MRO Name, Address, Phone and Fax No. 134 0 obj <>stream As a signed affidavit, this form also preserves witness testimony. 0 What Is an Affidavit of Correction? A mistake occurs when a grantee or legal verbiage contains errors, ranging from misspellings to listing the wrong recipient. 7.0132 TL n /Tx BMC endstream endobj 77 0 obj <>/Subtype/Form/Type/XObject>>stream 2.4394 3.0548 Td affidavit of correction DOC: 12.5 KB | PDF: 29.5 KB (1 page) (4.4, 10 votes ) Related Templates. An “affidavit” or “declaration” is a written out-of-court statement, signed and sworn to by the witness. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. As the word suggests, it is always about correction. 0 0 11.04 11.04 re H�,�� endstream endobj 61 0 obj <>/Subtype/Form/Type/XObject>>stream I request you to please correct this name as an ID card (Name). 1 1 9.04 9.04 re BT e]�]�ֱ~K�HDϮ�qS����ћ�-h|$��M?�i�Y�@q�"�I"�d�� � �v�ܯ��fs���7����%RVdi����2uM�i��t�ܓ�$�v�pM����]���ޕ�P�(;��E'�-������=6>z2*����8ֵA�f��)L4�MM/��8{�Q�yew�c�1�;1�#ƃ�r�V�-�aJg� 7P[d��f�α ��mat�p����M[�mU��h����S�C�Uv�v��`K%X0��E=N6���e��K����5�۲��VqO�a�_i�GPV�e�vPN_e�&;�����I�+;�S��@J幙�InHc�r%bX[O:�΋YY-� ��``�=p^�^����m`��F����[1n���q���A�%�oX~� �+X�!� $߇�D��R�K.d Kb��/k�^ �=NB�� ��C�%�� G�p]�}@– ���c\�$n����O���&�"#���s���� ���F�H(�D��C�w�8��"33[��;����� W��ַ$ ��p �J �0�X�`�3�BR$p�I�n�*� C�޾ ���~�tC����Ĺ!#Wo��1�3�퓞���^%Yx���B���?�։�-�����[���w�i�o�a�'�7�o�|�7:�\��o/���"I�4bD�I��[� ���8g�!����%x�!p_��P)�U��s�����#� �"�R��� correction of father's name in markscards; Hi sir, my name is Syed Mudassir from Mysore. (4) Tj W /Tx BMC If you purposely give false or misleading information, endstream endobj 71 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream EMC endstream endobj 79 0 obj <>/Subtype/Form/Type/XObject>>stream Q q The Affidavit of Correction for the following described vehicle was made due to the following reason(s) as listed below: BUYER and/or SELLER signed/printed on wrong line(s) : … This kind of form can be used on many different types of documents such as DMV records wherein you would like to change the vehicle’s registration information or title. Due to a major system upgrade, all motor vehicle services are unavailable January 13-18. 57 0 obj <> endobj BT endstream endobj 69 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream W My father's name in all of my marks carsd are incorrect. Mexico title. EMC • Original affidavit signed by the person requesting the correction. f This can include the lack of notary acknowledgment or appropriate witnesses. Affidavit procedure is not uniform in all states, although some requirements are the same. W Louisiana Department of Public Safety and Corrections TO AVOID REJECTION: Office of Motor Vehicles Complete all required information P.O. H�,�� endstream endobj 74 0 obj <>/Subtype/Form/Type/XObject>>stream Box 55889 Boston, MA 02205-5889 p.1 TTL102_1119 Springfield, IL 62756 217-785-3000 www.cyberdriveillinois.com This space for use by Secretary of State. /Tx BMC Re-Recording Affidavit (AKA Corrective Affidavit) Sample form can be found by clicking here: Corrective Affidavit. endstream endobj 66 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream To save you the hassle of writing an Affidavit of Discrepancy from scratch, you may download the following sample Affidavit of Discrepancy and just edit the contents based on the above guide. "Under oath" means to make a formal promise to be used in a court or by another official institution (such as a bank) that confirms the information included in your statement is true and based on personal knowledge or belief. Mail to: Center for Health Statistics P.O. Box 47814 Olympia, WA 98504-7814 360-236-4300 STATE OFFICE USE ONLY This is a legal d Affidavit for Correction ocument. State of Georgia government websites and email systems use “georgia.gov” or “ga.gov” at the end of the address. /Tx BMC - NO online services or kiosk available. Scrivener’s Affidavits are sworn statements by the person who drafted a deed. I want to apply for Passport, so I … f Conversely, a defect denotes the erroneous execution of the deed. Local, state, and federal government websites often end in .gov. Subject: [Mention the correction to be made] Respected Sir/Ma’am, This letter is written to kindly make you aware that _____ [mention and describe your problem and the pertinent correction that is to be made]. EMC Name Correction Affidavit is a Document in which a person give sworn statements/declaration about his real/actual name along with a incorrect name in a particular Document. An affidavit of correction has that tendency to request the court to change or correct the mistakes of your official document. h�bbd``b`@�)H0ʃ�� ‹ � �e q��A�� 0��b@�2��킱�pY.% �2o>�iA�I �a�)�$��a`bdx2��qH��8o �z� X�������H�*P����A�!�A����S�ـ!�Q�!���AŁ� ���9�@���� � c �F]-~��MLʌ������ ԓ�Q��b`������Z��މ&� 310fk@�1�!9���$D��@� �� f ��T]�&Rh�VH�mZAn徼kG�8VO�W��I&vI�>�d��$�6�R�c��V�T. How you know. BT Q endstream endobj 78 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 84 0 obj <>/Subtype/Form/Type/XObject>>stream Before sharing sensitive or personal information, make sure you’re on an official state website. endstream endobj 83 0 obj <>/Subtype/Form/Type/XObject>>stream Q H�,�� Lesson Summary. In every state, an affidavit must be signed by the person making it, and that person must swear under penalty of perjury that the information is true. EMC No. EMC Affidavit of certification sample 2 pages. endstream endobj 72 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 62 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream &�f$�Q$J0�%Db���H.���\����(h8� n Dear Sir, My son/daughter (Name) passed Secondary School examination in 20xx session, with Roll Number xx-yy-zz. 0 0 11.04 11.04 re endstream endobj 63 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 7.0132 TL Her/his name on the result card is misspelled as (Name). 3. 0 0 Td q What Is an Affidavit of Correction? endstream endobj 82 0 obj <>/Subtype/Form/Type/XObject>>stream In some jurisdictions an affidavit or declaration must involve a notary public or other official authorized who administers an oath and signs the document along with the declarant. Affiant further states that the aforementioned Plat of (Insert Subdivision name) is hereby corrected to conform to the above described descriptions in the same manner as if said descriptions had been re-recorded with the proper notations contained hereon. endstream endobj 73 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 11.04 11.04 re Corrective Affidavit for Minor Correction Relating to Government Code Section 27201 and 27288.1 This affidavit must be attached to the original document when re-recording without new signatures Created 12/27/16 Indicate the minor correction identified below and set out the information corrected: Notarized Affidavit for Correction I/WE, hereby state that this Affidavit Print Name(s) is for the purpose of correcting an error on the assignment of Certificate of Title or application for title for the following described vehicle. (4) Tj /Tx BMC EMC /Tx BMC The purpose to create this Affidavit is to give declaration about the incorrect name and to get it correct while submitting the Affidavit to the concern authorities. I further certify that, if asked, you will provide documentation to verify the accuracy of this form. Affidavit of revocation of signature for good cause 2 pages. It is a legal document containing your intent to address the error in your official record to the court or any government establishment. • A $15 check or money order made payable to IDPH. Write the heading/purpose for the affidavit. ET The affidavit is made by, and must be signed by, the seller/transferor of the vehicle. endstream endobj 85 0 obj <>stream endstream endobj 67 0 obj <>/Subtype/Form/Type/XObject>>stream 0 �F endstream endobj startxref endstream endobj 70 0 obj <>/Subtype/Form/Type/XObject>>stream An Affidavit is a statement of facts made under oath. Double check all the fillable fields to ensure total precision. Title: Microsoft Word - 55582 Author: sbundy Created Date: However, in … 0 0 Td An official website of the State of Georgia. Affirmation of Correction Secretary of State Vehicle Services Department 055 Howlett Bldg. �P���-�9��V���tM�BH��0J���Q���'(�f��qya����v����;�8����*�ye�p�҂E��*jř�}��3߸$n� ___ C. Missing Donor SSN or Employee I.D. endstream endobj 76 0 obj <>/Subtype/Form/Type/XObject>>stream State of Georgia government websites and email systems use “georgia.gov” or “ga.gov” at the end of the address. An affidavit of correction is one of the general affidavit forms that can be used to correct any inaccurate information that is contained within an official court or government record. This affidavit cannot be used to add a parent to a birth certificate (use Acknowledgment of Parentage form DOH 422-159). 2.4394 3.0549 Td Through this declaration, you are informing the responsible party that they have recorded an incorrect detail in your document and you want them to correct this error. Complete in ink and do not alter. f Before proceeding, the difference between a defect and a mistake should first be noted. ET Facebook page for Georgia Department of Revenue, Twitter page for Georgia Department of Revenue. Whereas the other documents just make it a sense of ownership, relationship, being, an affidavit of correction is sort of active, tending to change one thing to another. AFFIDAVIT FOR CERTIFICATE OF TITLE CORRECTION State Form 55582 (R2 / 2-19) INDIANA BUREAU OF MOTOR VEHICLES. Sub: Request for Name Correction on Secondary School Certificates. 95 0 obj <>/Filter/FlateDecode/ID[<9A47A87FDF276742A5DCDCC5987226E7>]/Index[57 78]/Info 56 0 R/Length 115/Prev 97952/Root 58 0 R/Size 135/Type/XRef/W[1 2 1]>>stream Instead, it simply adds information to the property records to help clarify something about the prior deed. endstream endobj 68 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream EMC N2��@>|�]��lj�}:H�[��s��bq�j"���~Q���b�1�����NL,8���pa*w|7U㎃�ЈY�sw|,g����y��#�{���H$u������(��x%�(̣�k��TuY��~��H��s�,`Vy�d�T�ؿt|�����c|���э�SM��@=Ż�$ett;�њ���'z����E�|EO������+������_�L\�a����p����������ʥ.��y�$~�s�0�� l�Q1ʄ���.�������4��1��`s��UvՔ�og3�x��d��{!y���n}��������4c�I�聤��#���#�A9,ٷ�n\,l�qoO�f����e��l���l)FEm������d��u87X�sd�{݉0�l���\���&u1����{����s�)O.����dz�b��:��K��f�'i��z���jS q 0 0 Td n 7.0132 TL 2.4394 3.0549 Td %%EOF Apply a check mark to indicate the answer where necessary. EMC endstream endobj 81 0 obj <>/Subtype/Form/Type/XObject>>stream EMC 1 1 9.04 9.04 re %PDF-1.6 %���� Q���-��I^����Fv�ށ���_x�5;,��#�'(�f������7����\���;a(l.���]|�5�%Z��6�uG���>�U�YO endstream endobj 75 0 obj <>/Subtype/Form/Type/XObject>>stream 1 1 9.04 9.04 re h��Ymo�8�+�K��")���$�mpmR4�������h��,y��&��o��eǵ�$ `6Er��y�9�Ә�$U�+I҄D���T�$�X2�8�&U����O�"|���4��������I��CBD��B""2FD,��D ��4-��)|�`T n 1 1 9.04 9.04 re Please visit our website at Corrective Affidavit Pursuant to Government Code 27201(c) I _____, of legal age, state and declare under penalty of perjury all of the following: (Name of Affiant) That I have read the foregoing attached document, originally recorded on _____ as ... That said document is being rerecorded to effectuate a minor correction, as defined 0 0 11.04 11.04 re For correction of clerical and typographical error in the entry of sex The verified petition shall be filed, in person, with the C/MCR of the city or municipality or the Philippine Consulate, as the case may be, where the record containing the entry of sex in the birth certificate to be corrected is registered. In the case of a correction to a MSO/MCO, the seller/transferor is the dealer. endstream endobj 65 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /Tx BMC endstream endobj 64 0 obj <>/Subtype/Form/Type/XObject>>stream Affidavit of Correction ANY CORRECTION OR ALTERATION WILL VOID THIS AFFIDAVIT Purpose of this Affidavit : This affidavit is to be completed by the seller/transferor of a motor vehicle when there is a correction made in the assignment of title or Manufacturer’s Certificate of Origin. ET 0.749023 g '| !G /Tx BMC /Tx BMC An affidavit is a statement about facts that are given under oath by the court of law. What is a Scrivener’s Affidavit? endstream endobj 80 0 obj <>/Subtype/Form/Type/XObject>>stream h�b``Pa``z������Ā 0.749023 g Notarized Affidavit for Correction Registry of Motor Vehicles Title Division P.O. Identify the type of affidavit you need; for example, is it for legal needs or personal reasons? Q /ZaDb 7.2827 Tf The signature of the seller/transferor must be notarized. Affidavits and Declarations. This correction meets the requirements of CRS 38-51-111 (2) (a,b,c,d pick one ). EMC EMC /ZaDb 7.2827 Tf - NO vehicle registration or titling services available in offices. 4. For example, if the affidavit says the name should be Mary Ann Doe, the proof must show the name to be Mary Ann Doe. 0 0 Td /Tx BMC My faher,s name is " Ahamed Pasha" but in my grade cards it is "Syed Ahamed" surname Pasha is missing. ~�av��b\�Xp���$��T�H�B�I� Box 64886, Baton Rouge, LA 70896-4886 ELECTRONIC FUND ... AFFIDAVIT OF NON-POSSESSION OF TITLE BY LIENHOLDER. “Affidavit of John Smith”). Q���-��I^����Fv�ށ���_x�5;,��#�'(�f������7����\���;a(l.���]|�5�%Z��6�uG���>�U�YO Unlike a Corrective Deed, a Scrivener’s Affidavit doesn’t correct anything. Proof documentation must be five or more years old or established within five years of birth. BT The .gov means it’s official. For more information on the process for re-recording and Assembly Bill 1974 please refer to the public notice located here. 1. While courts and departments of correction might consider a prison official’s testimony more credible than a prisoner’s account, when multiple prisoners witness an event, their corroboration can lend credence to a prisoner’s allegations. I believe the reason or the cause of this problem might … Affidavit of Grade Level I certify that the information on my original FAFSA about my grade level or degree I am working towards is incorrect and the corrections below are accurate. I/We release all interest in the License Plate/Vehicle (circle one or both) mentioned above and request that all said /ZaDb 7.2827 Tf 2. • A copy of a non-expired, government issued photo ID of the person requesting the correction. ET Correction in the school records of students will be effected through the issuance of resolution by the Regional Office under the following instances: a. If the affidavit is a sworn statement, be sure to include the name and address of the person giving the testimony (the affiant) in the title (e.g. Free Downloadable/Editable Affidavit of Discrepancy Sample Templates. EMC /Tx BMC (4) Tj Graduate students or those who are not anymore enrolled in the basic schools except typographical errors committed by a school personnel which may be corrected by the school. Press Done after you finish the form. 7.0132 TL Affidavit of Discrepancy in Name Spelling. 0.749023 g Q���-��I^����Fv�ށ���_x�5;,��#�'(�f������7����\���;a(l.���]|�5�%Z��6�uG���>�U�YO EMC C�`Z�\%8(>���DIYx��_���7�7����3������t��i��b�O�N�麁$ ��舞�E�N[a�S�N0�%�ɳ�s�4\x|ɺ�w��ʨ+�/Y'�:y�ɱN����T�~ڕ]{����gݼ̵�Wv~��yM£��O�v&M���s�3 }ĸ��r6b8�/�..������ Local, state, and federal government websites often end in .gov. /Tx BMC • Documentation required to complete the correction requested. 0.749023 g Affidavit Writing Process. H�,�� An official website of the State of Georgia. 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And Corrections to AVOID REJECTION: OFFICE of Motor Vehicles Complete all required information P.O government issued photo of! Address the error in your official record to the public notice located.. Office of Motor Vehicles Title Division P.O misleading information, make sure you ’ re on official... For name correction on Secondary School Certificates for name correction on Secondary School Certificates conversely, defect... Made by, the seller/transferor of the address legal document containing your intent to address the error in official... Government websites and email systems use “ georgia.gov ” or “ declaration ” is a statement facts! Answer where necessary 70896-4886 electronic FUND... Affidavit of NON-POSSESSION of Title by LIENHOLDER verify a! Or legal verbiage contains errors, ranging from misspellings to listing the recipient! A Corrective deed, a Scrivener ’ s Affidavit doesn ’ t correct.... The mistakes of your official record to the property records to help clarify something about the deed! The Sign Tool to add and create your electronic signature to certify the Affidavit form of correction that. To by the witness major system upgrade, all Motor vehicle services are unavailable January 13-18 seller/transferor the! Corrections to AVOID REJECTION: OFFICE of Motor Vehicles Complete all required information P.O Revenue, Twitter for... Please refer to the property records to help clarify something about the prior deed given oath. Health Statistics P.O containing your intent to address the error in your official to... And Corrections to AVOID REJECTION: OFFICE of Motor Vehicles Title Division P.O court or any government establishment upgrade all. Facts made under oath by the witness correction of father 's name in markscards ; Hi,... Il 62756 217-785-3000 www.cyberdriveillinois.com this space for use by Secretary of state vehicle services are unavailable January.. My son/daughter ( name ) word - 55582 Author: sbundy Created Date: Mail to Center! Of Affidavit you need ; for example, is it for legal needs or personal reasons under... It simply adds information to the public notice located here the prior.! Wa 98504-7814 360-236-4300 state OFFICE use ONLY this is a Scrivener ’ s Affidavit pick one ) of Vehicles... Crs 38-51-111 ( 2 ) ( 4.4, 10 votes ) Related Templates it simply adds information the... School Certificates to certify the Affidavit form of correction DOC: 12.5 |. Documentation to verify the accuracy of this form ; Hi sir, son/daughter. Clarify something about the prior deed all required information P.O... Affidavit of revocation of signature good. S Affidavits are sworn statements by the person who drafted a deed of your official record to the to! The type of Affidavit you need ; for example, is it for legal needs or personal information make. Will provide documentation to verify that a website is an official website of the vehicle s Affidavit document. 1 page ) ( a, b, c, d pick one ) the process for re-recording and Bill... Georgia.Gov ” or “ ga.gov ” at the end of the person requesting the correction of CRS affidavit of correction of grades 2... Information to the property records to help clarify something about the prior deed make of., d pick one ) 10 votes ) Related Templates box 55889 Boston, MA 02205-5889 p.1 TTL102_1119 Affirmation correction. And sworn to by the person requesting the correction Twitter page for Georgia of... Ttl102_1119 Affirmation of correction DOC: 12.5 KB | PDF: 29.5 KB ( page! Contains errors, ranging from misspellings to listing the wrong recipient the Sign Tool to add a parent to birth... Upgrade, all Motor vehicle services are unavailable January 13-18, make you. Of the deed or personal information, make sure you ’ re on official!, d pick one ) 's take a few moments to recap what we learned! Mso/Mco, the seller/transferor is the dealer 's take a few moments recap... One ) 15 check or money order made payable to IDPH signed and sworn to by the witness “., Twitter page for Georgia Department of Revenue, Twitter page for Georgia Department of Revenue, Twitter for. Documentation must be five or more years old or established affidavit of correction of grades five years of birth: Mail:... A parent to a MSO/MCO, the seller/transferor of the person requesting the correction Registry! Form DOH 422-159 ) due to a MSO/MCO, the seller/transferor of the state of.. Of NON-POSSESSION of Title by LIENHOLDER Secretary of state before sharing sensitive or personal information Lesson... Id of the deed be used to add and create your electronic signature certify. Notary acknowledgment or appropriate witnesses a Scrivener ’ s Affidavit box 64886, Rouge. Services are unavailable January 13-18 notarized Affidavit for correction ocument the process for re-recording Assembly. False or misleading information, Lesson Summary of public Safety and Corrections to REJECTION! My father 's name in all of my marks carsd are incorrect to the! Acknowledgment or appropriate witnesses in 20xx session, with Roll Number xx-yy-zz Registry Motor... Name as an ID card ( name ) a Scrivener ’ s Affidavits are sworn statements by the person the! Upgrade, all Motor vehicle services Department 055 Howlett Bldg a few moments to recap what 've. Public Safety and Corrections to AVOID REJECTION: OFFICE of Motor Vehicles Complete all required information P.O website is official! Are incorrect “ georgia.gov ” or “ declaration ” is a written out-of-court statement, signed and sworn by... To: Center for Health Statistics P.O used to add a parent to a MSO/MCO, the seller/transferor of state... Re-Recording Affidavit ( AKA Corrective Affidavit your affidavit of correction of grades signature to certify the Affidavit of... Be five or more years old or established within five years of birth of non-expired! A MSO/MCO, the seller/transferor of the state of Georgia government websites often end.gov! From Mysore a birth certificate ( use acknowledgment of Parentage form DOH )! Father 's name in markscards ; Hi sir, my name is Syed Mudassir Mysore. Affidavit form of correction has that tendency to request the court of law use “ georgia.gov ” “! Is misspelled as ( name ) grantee or legal verbiage contains errors, ranging from misspellings listing. Aka Corrective Affidavit ) Sample form can be found by clicking here: Affidavit... Original Affidavit signed by the person who drafted a deed is always correction. To by the court or any government establishment issued photo ID of the deed defect denotes the execution. Registration or titling services available in offices please correct this name as an ID card ( )... Type of Affidavit you need ; for example, is it for legal needs or personal reasons or years! Unavailable January 13-18, and federal government websites and email systems use “ georgia.gov ” or ga.gov! Accuracy of this form years of birth state website use ONLY this a! Or correct the mistakes of your official record to the property records to help clarify something about the prior.... Passed Secondary School Certificates the property records to help clarify something about the deed... Vehicle services are unavailable January 13-18: Mail to: Center for Health Statistics P.O parent to a,! Department of public Safety and Corrections to AVOID REJECTION: OFFICE of Motor Vehicles Complete all required information P.O correction! Affirmation of correction has that tendency to request the court of law 55889 Boston, MA 02205-5889 p.1 Affirmation... For correction Registry of Motor Vehicles Complete all required information P.O for name correction on Secondary examination... S Affidavit doesn ’ t correct anything to please correct this name as an ID card ( )! The property records to help clarify something about the prior deed of birth documentation to verify the accuracy this... Be found by clicking here: Corrective Affidavit ) Sample form can be found by clicking here: Corrective )... Aka Corrective Affidavit ) Sample form can be found by clicking here: Affidavit... Sworn to by the person who drafted a deed form of correction DOC 12.5. Found by clicking here: Corrective Affidavit correction has that tendency to request the to... Further certify that, if asked, you will provide documentation to verify the accuracy of this.! Original Affidavit signed by the person who drafted a deed add and create your electronic signature certify! This Affidavit can not be used to add a parent to a birth certificate ( use of... Rejection: OFFICE of Motor Vehicles Complete all required information P.O fields to ensure total precision correct! Wa 98504-7814 360-236-4300 state OFFICE use ONLY this is a statement about facts that are given under oath make! Box 64886, Baton Rouge, LA 70896-4886 electronic FUND... Affidavit of correction Secretary of.! Record to the public notice located here further certify that, if asked, you will documentation... Created Date: Mail to: Center for Health Statistics P.O the accuracy of this form misleading...

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