AFFIDAVIT OF NON-RESPONSIBILITY

STATE OF CALIFORNIA
COUNTY OF SAN FRANCISCO

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YOUR NAME, being duly sworn, deposes, swears and states:

1. I make this affidavit under penalty of perjury. The statements set forth herein are true and
are made on my personal knowledge.
2. I have received City of Oakland Parking Citation No. XXXXXX for California license
number CA XXXX for a Color Make Model, issued 03/20/13.
3. I am not the owner of the automobile cited, and was not the owner of the automobile on
the date of the citation.
4. I had sold the automobile to John Doe on 3/11/2013 as indicated on the attached bill of
sale.
5. Accordingly, I am not responsible for the citation for which I received notification.
DATED this _______ day of ________________________, 2013.

______________________________________
YOUR NAME
SUBSCRIBED AND SWORN before me this ______ day of __________________, 2013.

[NOTARY SEAL]

______________________________________
NOTARY PUBLIC
MY COMMISSION EXPIRES:
______________________________________

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AFFIDAVIT OF NON-RESPONSIBILITY