Form D-2 - Late Monthly Sales Reports
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1
2Salvage,Crusher,Recycler,Scrap Metal Recycler, Rebuilder On
Dealer #
Folder#
D-2 www(0909)
FEIN Number
Dealership Name
SS #
Total Salvage Only Sales
Dealer Address:
Monthly Report for:
1
Date of Sale
Purchaser:
Name
City
State
Zip Code
Address
Odometer Reading
Vehicle Information:
Title Surrendered
Y___ N____
Year
Make
VIN
2
Date of Sale
Purchaser:
Name
City
State
Zip Code
Address
Odometer Reading
Vehicle Information:
Title Surrendered
Y___ N____
Year
Make
VIN
3
Date of Sale
Purchaser:
Name
Address
City
State
Zip Code
Odometer Reading
Vehicle Information:
Title Surrendered
Y___ N____
Year
Make
VIN
4
Date of Sale
Purchaser:
Name
City
State
Zip Code
Address
Odometer Reading
Vehicle Information:
Title Surrendered
Y___ N____
Year
Make
VIN
5
Date of Sale
Purchaser:
Name
Address
City
State
Zip Code
Odometer Reading
Vehicle Information:
Title Surrendered
Y___ N____
Year
Make
VIN
By my signature, I swear or affirm that this is a true and correct statement. I am aware that law provides severe penalties for making false statements.
Name
Signature
Title
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Parent category: Business