Section 3 of 11
Reporting Documents
3.040 Completing a Notice of Acquisition/Report of Vehicle To Be Dismantled
| Fields | Information | |
|---|---|---|
| Fields
1 | Information
27 | Expiration date of the last registration |
| Fields
2 | Information
26 | State in which the vehicle was last registered |
| Fields
3 | Information
25 | License plate number on the vehicle |
| Fields
4 | Information
21 | Vehicle identification number (VIN) |
| Fields
5 | Information
22 | Engine number (motorcycles) |
| Fields
6 | Information
| DMV use only |
| Fields
7 | Information
23 | Make of the vehicle |
| Fields
8 | Information
| Body type of the vehicle |
| Fields
9 | Information
24 | Year model of the vehicle |
| Fields
10 | Information
| Date vehicle was purchased by the dismantler |
| Fields
11 | Information
28 | Date the dismantler took possession of the vehicle |
| Fields
12 | Information
29 | Name/address of the person from whom the dismantler purchased the vehicle |
| Fields
13 | Information
| Check the appropriate boxes to indicate the items being submitted |
| Fields
14 | Information
| Check the appropriate box to indicate the condition of the vehicle |
| Fields
15 | Information
| Check the appropriate box to indicate the disposition of the license plates |
| Fields
16 | Information
| Date the Report of Vehicle to be Dismantled was signed |
| Fields
17 | Information
31 | Signature of the authorized person completing the form |
| Fields
18 | Information
32 | Firm name of the licensed dismantler |
| Fields
19 | Information
33 | Dismantler’s occupational license number |
| Fields
20 | Information
34 | Dismantler’s address |
| Fields
30 | Information
| Date the Notice of Acquisition was signed |