STATE OF FLORIDA
DEPARTMENT OF HIGHWAY TITLE SURETY BOND
SAFETY AND MOTOR VEHICLES FOR A MOTOR VEHICLE
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KNOW ALL PERSONS BY THESE PRESENTS: BOND NUMBER: __________________________

That I/we ______________________________________________________________________________________, as Principal and

______________________________________________________________________________________, a Surety Company,

qualified to do business in the State of Florida, as surety are held and firmly bound unto the duly appointed and qualified Director of the Division of
Motorist Services of the State of Florida, and the successors in office of said Director, in the penal sum of $_________________, which is twice the
value of the vehicle established by a current Kelly Blue Book valuation guide for the payment which, well and truly to be made, we do hereby jointly
and severally bind ourselves, our heirs, legal representatives, successors and assigns, firmly by these presents:

WHEREAS, the Principal has been unable to provide a certificate of title that assigned the prior owner’s interest in the vehicle and has
submitted an application and affidavit to the Department of Highway Safety and Motor Vehicles of the State of Florida for a Certificate of Title on
this certain vehicle described to wit:

YEAR ________ MAKE ________________________ BODY TYPE ______________ CURRENT RETAIL VALUE: $ ____________________

FLORIDA TITLE NUMBER __________________ VEHICLE IDENTIFICATION NUMBER _______________________________________

AND WHEREAS, the Principal and Surety herein desire to comply with the provisions of Florida Statute 319.23(7) to submit a properly
executed surety bond conditioned as set forth below.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT:
If the aforesaid Principal shall indemnify all prior owners and lienholders and all subsequent purchasers of the vehicle or persons who acquire a
security interest in the vehicle, and their successors in interest, against any expense, loss, or damage, including reasonable attorney fees, occurring
because of the issuance of the certificate of title for the vehicle or for a defect in or undisclosed security interest on the right, title, or interest of the
applicant to the vehicle, this obligation shall be void; otherwise, it shall remain in full force and effect. This bond to be effective on the

___________ day of ____________________, _________, and to expire three (3) years from the effective date of said bond.
PROVIDED, HOWEVER, that an interested person has a right to recover on the bond for a breach of the bond’s condition. The
aggregate liability of the surety to all persons may not exceed the amount of the bond.
IN WITNESS WHEREOF, the above bounden parties have executed this bond under their several seals this ___________ day of

____________________, _________, the name and corporate seal of each corporate party being affixed hereto, and these presents duly signed by its
undersigned representatives, pursuant to authority of its governing body. This bond is null and void unless signed by the Principal and Surety. When
executed by an attorney-in-fact, the power of attorney (original copy) must be attached. Any alteration of this document necessitates the issuance of
a new bond or an attached amendment from the Surety Company.

TYPED NAME OF PRINCIPAL (OWNER & CO-OWNER, if applicable) SIGNATURE OF PRINCIPAL (OWNER)

SIGNATURE OF PRINCIPAL (CO-OWNER, if applicable) SIGNATURE OF SURETY AGENT (SEAL)

TYPED NAME OF SURETY BOND COMPANY TYPED NAME OF SURETY AGENT

ADDRESS OF SURETY BOND COMPANY ADDRESS OF SURETY AGENT

CITY/STATE/ZIP CODE CITY/STATE/ZIP CODE

TELEPHONE NUMBER TELEPHONE NUMBER

HSM V 82033 (REV. 11/19)