Affidavit for a Low Speed Vehicle Converted to a Golf Cart
If a low-speed vehicle is converted to a golf cart, the owner of that vehicle has to execute the following affidavit. This affidavit shows the compliance with speed restrictions.
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FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
AFFIDAVIT FOR A LOW SPEED VEHICLE
CONVERTED TO A GOLF CART
Name ______________________________ Street Address ______________________________
City _____________________________ State ______________ Zip Code _________________
Florida Vehicle Identification Number ______________________________________________
Florida Title # ______________________ Florida License Plate# ________________________
I/We _________________________________________________________________________
hereby certify that the low speed vehicle converted to a golf cart described above has been
modified to comply with the speed restrictions in s. 320.01 (22) (not capable of exceeding speeds
of 20 miles per hour) and acknowledge that the vehicle must be operated in accordance with
s. 316.212, s. 316.2125, s. 316.2126, or s. 316.21265.
UNDER PENALTIES OF PERJURY, I/WE DECLARE THAT I/WE HAVE READ THE
FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
____________________________________ _________________________________________
SIGNATURE OF APPLICANT (OWNER) PRINTED NAME OF APPLICANT (OWNER)
____________________________________ _________________________________________
SIGNATURE OF APPLICANT (CO-OWNER) PRINTED NAME OF APPLICANT (CO-OWNER)
(if applicable) (if applicable)
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