Legal Forms, Documents and Contracts

Over 4550 free forms and legal documents. Find and download the one you need!

Vehicle Identification Number and Odometer Verification

The following Affidavit has to be executed by the rightful owner of the concerned vehicle. The vehicle’s owner has to physically inspect the vehicle and make sure of its condition. The owner is required to record the vehicle’s identification information such as the identification number, the odometer reader, and its certification.

Download

Extracted Text for Proper Search

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES 
DIVISION OF MOTORIST SERVICES 	
 	
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE 	www.flhsmv.gov/offices/	 	  	
VEHICLE IDENTIFICATION NUMBER AND ODOMETER VERIFICATION 	 	 	PART A - OWNER’S VEHICLE IDENTIFICAT ION AFFIDAVIT AND ODOMETER DECLARATION 
  (Completion of this part requires a physica l inspection of the vehicle by the owner) 
 AFFIDAVIT: 	 	                DATE: ____________________ 	 This is to certify that I, the undersigned, am the lawful owner  of the motor vehicle described on this form and that I have, 
on the date entered above, made a physical  inspection of the motor vehicle and have recorded the vehicle identification 
number and other identification informati on and the odometer reading and certification  in the spaces provided on this form. 
 
VEHICLE IDENTIFICATION     	(MOTOR NUMBER ALL MAKES THROUGH 1954 - IDENTIFICATION NUMBER 1955 AND L\
ATER)	 	 	
Vehicle Identification Number  Year  Make  Color  Body 	Previous State Vehicle Titled In 	
 
ODOMETER DECLARATION  WARNING:   Federal and State law require that you stat e the mileage in connection with an application for a 
Certificate of Title.  Failure to complete or providing  a false statement may result in fines and/or imprisonment. 
 
I /WE STATE THAT THIS  	 5  OR  	 6 DIGIT ODOMETER NOW READS 	 	 	 , 	 	 	 .XX (NO TENTHS) 
MILES, DATE READ _______/_______/_______ AND I/WE HEREBY CE RTIFY THAT TO THE BEST OF MY KNOWLEDGE 
THE ODOMETER READING: 	
 	
 1	.  reflects ACTUAL MILEAGE.     	  2.  is IN EXCESS OF ITS MECHANICAL LIMITS.     	 3.  is NOT THE ACTUAL MILEAGE. 	 	
UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING  DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE. 	
 
_________________________________________________  _____________________\
_________________________ 	
(Owner’s Signature)      (Owner’s Printed Name) 	  PART B – VERIFICATION OF THE VEHICLE IDENTIFICATION NUMBER  This section requires a physical inspection and a verification of  the vehicle identification number (VIN) (or the motor number  for motor 
vehicles manufactured prior to 1955) of t he motor vehicle described on this form by a Florida Notary Public, Licensed Dealer, P olice 
Officer, or Florida Division of Motorist Services Employee or  Tax Collector Employee.  If an out-of-state motor vehicle dealer verifies the 
VIN, the verification must be submitted on their letterhead stationery.  Complete this  section on all used motor vehicles, including trailers, 
(with abbreviation of “TL” with a  weight of 2,000 pounds or more) not  currently titled in Florida.   
 
I, the undersigned, certify that I have physi cally inspected the above described vehicle and find that the vehicle identification number on 
the vehicle to be identical to the vehicle identification number recorded on this form.	
          	                                                                                     	(Seal)  	
Date:     	 	
 
Commissioned Name of Florida Notary:	 _______________________________ Notary’s Signature: ________________________________	 	                     	(Print, Type or Stamp) 	 UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FORE GOING DOCUMENT AND THAT THE FACTS 
STATED IN IT ARE TRUE.    
 If other than a Notary, check the box below that applies and sign and complete the corresponding fields.  Verified by:  
        	Florida Compliance Examiner/Inspector(DMS/TC Employee)          	  Law Enforcement Officer          	   Florida Licensed Dealer        	   	 
Signature: ______________________________________  Printed Name: __________________\
____________________________ 
 Florida Compliance Exam iner/Inspector Name: 	        	__ 	 Badge or ID #:     _____________	 
 	
Law Enforcement Agency Name: 	                                             	 LEO Badge #: 	  	_____________	 	
 
Florida Dealer Name: 	           	  Florida Dealer #: _______________________________ 	    	
♦  	NOTICE:  ANY ALTERATION OR E RASURE MAY VOID THIS DOCUMENT 	♦ 	 	HSMV 82042 (REV. 01/13)                                            www.flhsmv.gov

WHO IS AUTHORIZED TO COMPLETE THIS FORM?	 
ANY PERSON OR AUTHORIZED  AGENT OF ANY PERSON REQUIRED TO  MAKE APPLICATION FOR CERTIFICATE 
OF TITLE AND/OR REGISTRATION. 
 
WHEN SHOULD THIS FORM BE COMPLETED?	
 
ON ALL USED MOTOR VEHICLES, INCLUDING TRAILERS  NOT CURRENTLY TITLED IN FLORIDA, WITH A NET 
WEIGHT OF 2,000 POUNDS OR MORE. 
 
WHEN SHOULD THIS FORM NOT BE COMPLETED?	
 
WHEN CERTIFICATE OF TITLE IS BEING  APPLIED FOR ON ONE OF THE FOLLOWING: 
1.  NEW MOTOR VEHICLE, REGARDLESS OF WHETHER PURCHASED IN FLORIDA OR  
 OUT-OF-STATE 
2. MOBILE HOME 
3.  TRAILER OR SEMITRAILER WITH A  NET WEIGHT OF LESS THAN 2,000 POUNDS 
4.  TRAILER TYPE RECREATIONAL VEHICLE (TRAVEL TRAILERS AND CAMP TRAILERS) 
 
VIN VERIFICATION BY AN OUT OF STATE MOTOR VEHICLE DEALER:	
 
 
IF THE VEHICLE IDENTIFICATION NUM BER (VIN) IS VERIFIED BY AN OUT-OF-STATE MOTOR VEHICLE DEALER, 
THE VERIFICATION MUST BE SUBMITTED  ON THEIR LETTERHEAD STATIONERY. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Check your local phone book government pages or visit the following website for current mailing addresses : 
http://www.flhsmv.gov/offi ces/	
 
 
 	
HSMV 82042 (REV. 01/13)                                        www.flhsmv.gov
Next: Virginia Putative Father Request to Search Registry Previous: Vehicle Air Pollution Control Statement
If you want to remove Vehicle Identification Number and Odometer Verification from this website please contact us providing the reasons together with this url: https://formsarchive.com/vehicle-identification-number-and-odometer-verification/

Leave a Reply

Your email address will not be published. Required fields are marked *

You can use these HTML tags and attributes <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>