Declaration

  ​By submitting this form, I hereby certify under penalty of perjury under the laws of the State of California that the information entered by me on this document is true and correct and I have no information or belief that there is a valid defense to the claims which give rise to the lien(s).  I have verified the below vehicle for correct valuation, license plate and vehicle identification numbers. Lewis Lien Sales will assume no responsibility for illegible or missing information.  I appoint Lewis Lien Sales as Power of Attorney and authorize Lewis Lien Sales or its employees to sign on my behalf for the below vehicle or vessel.