A short affidavit with a very long blank in the middle of it, and the blank is the form. You are asking the commissioner to issue a title on evidence that falls short of an assignment, and in exchange you promise not to hold him or the state responsible if it turns out badly. Its usual home is the good-faith possession route: a trailer, light trailer, boat trailer, farm trailer, travel trailer or manufactured home that has never been titled anywhere and for which the department has no record at all.
Written against DPSMV 1976 (Rev 04/06/2026), issued under R.S. 32:707.4, alternate procedures to transfer certain vehicles. Revised 6 April 2026. The form itself never mentions the good-faith possession procedure, the one-year wait or the inspection requirement - all of that lives in the department's policy rather than on the sheet, which is why a page written from this form's title alone would be almost entirely wrong about what it is for.
Two documents, and they are not the same thing. Take the blank DPSMV 1976 from the public.powerdms.com copy so you get the revision that is current today.
This is the actual DPSMV 1976, rendered from the PDF the Louisiana Office of Motor Vehicles publishes and completed end to end: letterhead, every field, and the blocks at the foot.
The blank in the opening sentence.
Watch out: The person who will hold the title if it issues. This affidavit is personal - it is your indemnity, not the vehicle's - so a company here needs a representative named in the signature block as well.
The full-width rule after the words issue a title covering.
Watch out: Year, make, model, body style and VIN, all of them. A trailer with no VIN plate at all is a different and much longer problem, and it starts with the physical inspection rather than with this form.
Eleven ruled lines occupying the middle half of the page.
Watch out: Write the actual history: how the vehicle came to you, when, from whom, what has been done to find the owner, and what the department's own record search shows. This is the paragraph a supervisor reads when deciding whether to issue a title on no evidence of ownership.
Two boxes on one row, under the reason lines.
Watch out: The date here should match the date in the jurat below. Two different dates on one affidavit means it was signed before it was sworn, which is the thing the jurat exists to deny.
The jurat line, with the notary's signature, printed name and identification number beneath it.
Watch out: The notary block on this sheet labels all three positions explicitly - signature, printed name, ID. Filling in two of the three is the version of this form that comes back.
| On the form | What to put in it |
|---|---|
| The said appearer, ______, declares | The opening blank, for the name of the person swearing it. |
| should the Motor Vehicle Commissioner of the State of Louisiana issue a title covering (vehicle description) | A full-width rule for the description. Year, make, model, body style and VIN together, because a title is being asked for on the strength of this sentence. |
| That he does not hereby guarantee title | The first half of the undertaking, printed. |
| and agrees to save and hold harmless the said commissioner and any other employees of the State of Louisiana from any and all liability whatsoever for having issued the said title | The indemnity, printed. It runs on to cover all subsequent purchasers and any loss incurred by reason of having issued the requested title. |
| The reason for executing this affidavit is as follows | Eleven ruled lines. This is the whole substance of the document and there is no guidance printed anywhere on the sheet about what belongs in them. |
| Signed, Date | Two boxes on one row. |
| Sworn and subscribed before me this __ day of __, 20 __ | The jurat. |
| Notary Signature, Notary Printed Name, Notary ID | Three labelled positions on one rule at the foot, and unlike most OMV forms this one names the identification number explicitly. |
Every line here was read off DPSMV 1976 (Rev 04/06/2026) itself — the PDF is here — and off the Louisiana Office of Motor Vehicles pages. This is plain-language help with a form, not legal advice, and where our wording and the agency's differ, theirs governs.
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