Form 761A-MC Revised 10-2013 MVC Oklahoma Tax Commission - Motor Vehicle Division Affidavit of Assembly and Ownership for Motorcycle/Trike State of Oklahoma, County of_________________________________________ I hereby attest to the following facts and information. I understand that any false statement submitted in this affidavit subjects me to prosecution pursuant to 47 OS Section 4-108. Please refer to the reverse for instructions and information on proper usage of this Affidavit. Original receipts/bills of sale are required for each of the following components (see reverse). Each column must be completed. Description of Major Components Purchased From Ownership Documentation (i.e. Assigned Title, Bill of Sale) Serial Number List Serial Number/VIN of Frame Frame: In None, ChecK Box Fork/Front End: Motor: Transmission: Trike: Body Material/Kit Total purchase price of all components utilized to assemble this motorcycle/trike: $ . (Total Purchase Price is to reflect the total cost you paid for all parts utilized to construct this motorcycle/trike, less the cost of those parts on which sales tax was paid.) I, the undersigned, state that to the best of my knowledge, there are no liens or claims on this assembled motorcycle/trike, or any of its component parts. I further agree to indemnify and save harmless the State of Oklahoma, its agencies, and subsequent purchasers of said property, for any loss they may suffer resulting from titling and registering the above assembled motorcycle/trike and to agree to warrant and defend title to this motorcycle/trike against any and all claims. __________________________________________________________________________________________________________ Print Firm Name or Individual Name (The title will be issued in this name) ____________________________________________________________________________________________________, Owner Signature Address:___________________________________________________________________________________________________ __________________________________________________________________________________________________________ City State Zip Subscribed and sworn to before me this _________ day of ___________________________, ____________. My commission expires: ___________________ , __________ . __________________________________________ , Notary Public Notary Seal Form 761A-MC - Page 2 Affidavit of Assembly and Ownership for Motorcycle/Trike Purpose / Use of Affidavit This affidavit is to be utilized in applying for an Oklahoma certificate of title for a motorcycle/trike that has been constructed from major components (normally displaying vehicle identification/serial numbers) taken from two (2) or more separate motorcycles, or from a combination of new major components (identified by Manufacturers Statements of Origin) and used components taken from an existing motorcycle. • Replacement of a motor or transmission alone does not constitute using this Affidavit. • Utilize Form 761A in applying for title to a automobile/truck/travel trailer. Documentary Requirements for Assembled Motorcycles Original receipts bills of sale and/or invoices should be supplied for all used numbered components such as frames, fork/front, motor, transmissions and trike (body material/kit). New numbered components should have original Manufacturer’s Statements of Origin (M.S.O.’s), which should be properly assigned to the individual building the vehicle. For Assembly of a Kit: Both the Manufacturer’s Statement of Origin (M.S.O.) and invoice issued at time of purchase must be submitted with this form. The invoice will aid in determining the content of the kit (frame, etc). The applicant is to provide either an assigned title OR a separate notarized bill of sale for the donor vehicle (vehicle which is used for parts only) if the frame, engine and transmission are not listed on the invoice as part of the kit. Submission / Contact Information Submit this completed form and required documentation to: Oklahoma Tax Commission Motor Vehicle Division Title Section 2501 North Lincoln Boulevard Oklahoma City, OK 73194 In state toll free telephone: 1-800-522-8165 ext 13221 Direct Telephone: (405) 521-3221 Website: www.tax.ok.gov Notice Approval of this Affidavit and issuance of an Oklahoma title and registration is not a confirmation of the roadworthiness of this vehicle. It is the applicant’s responsibility to ensure compliance with all applicable federal and state safety requirements.