Declaration of Non-Responsibility

This form lets a vehicle owner respond to a violation notice by reporting that the vehicle was stolen, sold, or under another person’s care.

What this form is

A recipient who was not driving can use this form to report that the vehicle was stolen, sold, or under another person’s care when the violation occurred. It asks for the notice and plate numbers, details about the vehicle’s driver or custodian, and the signer’s contact information and declaration. The form also includes space for a written statement for a mitigation or contested hearing.

Who needs it

A person who received a violation notice and was not driving the cited vehicle can use this form to provide information about its status or driver.

How to submit it

Complete and sign the form, then mail it to Lynnwood Municipal Court, 19321 44th Ave W, Lynnwood, WA 98036.

About notarization

This document is signed without a notary; the signer declares under penalty of perjury that the information is true and accurate.

How to submit this form

1
Download The Form
Download the Declaration of Non-Responsibility.
2
Complete The Form
Enter the violation notice and plate numbers, vehicle status, driver or custodian information, and your contact details.
3
Sign And Date
Sign and date the declaration, affirming that its information is true and accurate under penalty of perjury.
4
Mail To The Court
Mail the completed form to Lynnwood Municipal Court, 19321 44th Ave W, Lynnwood, WA 98036.

Frequently asked questions

Do I need a notary for the Declaration of Non-Responsibility?: No. The form does not require a notary, but the signer declares under penalty of perjury that the information is true and accurate.
Who can use this form?: A recipient who was not driving can use it to report that the vehicle was stolen, sold, or under another person's care when the violation occurred.
How do I submit the Declaration of Non-Responsibility?: Complete and sign the form, then mail it to Lynnwood Municipal Court, 19321 44th Ave W, Lynnwood, WA 98036.

Need something notarized?

This Declaration of Non-Responsibility doesn’t need a notary — but if you have another Lynnwood form that does, a commissioned online notary can help.