Form Mvt 5-10 - Motor Vehicle Inspection By A Government Official

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MVT 5-10
A
D
R
LABAMA
EPARTMENT OF
EVENUE
6/09
M
V
D
OTOR
EHICLE
IVISION
FOR USE BY
LICENSING OFFICIALS
Montgomery, Alabama 36132
ONLY
Motor Vehicle Inspection
by a Government Official
PART I – Vehicle Inspection (complete in full)
NOTE: Examine Public VIN Plate and make certain that the rivets are intact and the VIN has not been altered.
Vehicle Identification Number: ___________________________________________________________________________________
Make: ______________________________ Year: ______________________________ Model: _____________________________
Body Type: ___________________________________________
Number of Cylinders: ___________________________________
Color:________________________________________________
Odometer Reading: _____________________________________
Other Description or Comments (if any): ___________________________________________________________________________
____________________________________________________________________________________________________________
I hereby certify that I completed the information above from a physical inspection of the motor vehicle and that all infor-
mation is true and correct.
Name of Official (Print): _________________________________________________________________________________________
Signature: ________________________________________________________ Date: __________________________________
Agency: _____________________________________________________________ Phone No.: ______________________________
Agency Address: _____________________________________________________________________________________________
________________________________________________________________________________ Zip Code: ___________________
PART II – Appointment of Deputy by a Licensing Official
I hereby accept the certification of physical inspection of the motor vehicle as completed above and I appoint this official as
my deputy for the purpose of this physical inspection required of me personally or through any of my deputies by State
law. I further certify that the vehicle identification number and vehicle description completed above are the same as the
information shown on the application for certificate of title and/or registration.
Signature: ________________________________________________________ Date: __________________________________
Licensing Official: __________________________________________ Designated Agent No.: ________________________________
NOTE: This form may be provided to owners of motor vehicles that cannot be driven or delivered to the licensing
official’s office for a physical inspection because of the size of vehicle or for other special reasons.
Please instruct the owner to deliver this form and the vehicle to a government official for inspection.
Please be reminded that the vehicle to be titled or registered must be located in Alabama.
THIS FORM MAY BE REPRODUCED

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