JUNK FRAME STATEMENT MV2731 4/2014 WI Admin. Code Trans 149 & 305.23 Wisconsin Department of Transportation (WisDOT) http://wisconsindot.gov I certify that the vehicle frame on the junked vehicle listed below has not been damaged. The frame is sound and able to be used to repair a vehicle as of the date this form is signed. I also understand that any person who knowingly makes a false statement to the Wisconsin Department of Transportation in an application for title is guilty of a Class H Felony under s.342.06(02) Wisconsin Stats. X X (Supplier Signature) (Date – m/d/yyyy) (Buyer/Authorized Agent Signature) (Date – m/d/yyyy) This form must be submitted with the repaired salvage vehicle application to the Wisconsin Salvage Vehicle Inspector. FRAME SUPPLIER or FRAME SELLER If not typed, complete form using BLUE or BLACK ink. Name (first, middle initial, last) Dealer or Salvage Dealer Number Address, City, State, ZIP Code FRAME FROM VEHICLE Year Make Model Vehicle Identification Number (VIN) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
JUNK FRAME STATEMENT MV2731 4/2014 WI Admin. Code Trans 149 & 305.23
Wisconsin Department of Transportation (WisDOT) http://wisconsindot.gov
I certify that the vehicle frame on the junked vehicle listed below has not been damaged. The frame is sound and able to be used to repair a vehicle as of the date this form is signed.
I also understand that any person who knowingly makes a false statement to the Wisconsin Department of Transportation in an application for title is guilty of a Class H Felony under s.342.06(02) Wisconsin Stats.
X X (Supplier Signature) (Date – m/d/yyyy) (Buyer/Authorized Agent Signature) (Date – m/d/yyyy)
This form must be submitted with the repaired salvage vehicle application to the Wisconsin Salvage Vehicle Inspector.
FRAME SUPPLIER or FRAME SELLER If not typed, complete form using BLUE or BLACK ink. Name (first, middle initial, last)
Dealer or Salvage Dealer Number
Address, City, State, ZIP Code
FRAME FROM VEHICLE Year
Make
Model
Vehicle Identification Number (VIN)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Related Documents
