Form Hsmv-84015 S - Dealer Records Inspections Report
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4Division of Motor Vehicles
Dealer Records Inspections Report
For Office Use Only
_________________
Investigator: ___________________________________________
Date:
License Number: _______________________
Follow-Up?
Yes
No
If follow-up what is focus? Section
I
II
III
IV
V
If yes,
30 days
60 days
90 days
Dealer’s Name: _______________________________________________________
Case Number: __________________________
Dealer’s Address: _____________________________________________________
_______________
Graded By: ____________________________
City: ___________________________________ Zip Code:
Area Code and Telephone Number: _______________________________________
Section I: DISPLAYED FOR SALE
Licensee is required to possess a duly assigned certificate of title for each used vehicle offered for sale or have other approved
indicia of ownership which, according to Section 320.27(7), Florida Statutes (F.S.), and Rule 15C-7, Florida Administrative Code
may be: a manufacturer’s certificate of origin, a consignment contract, court order, photocopy of title from financial institution,
canceled check or other documentation showing satisfied lien, vehicle purchase order or installment contract identifying vehicle as a
trade-in, or a duly executed odometer disclosure statement. Section 320.27(9)(i), F.S., requires an odometer disclosure statement.
Section 320.27(9)(a), F.S., requires a buyer’s guide.
Odometer
Disclosure or
Title
Buyer’s
Veh.
Title
Vehicle
Properly
Indicia?
Guide
No.
No.
State
Exempt?
Assigned?
Explain
1
Yes
No
Yes
No
Yes No
Year/Make
VIN
2
Yes
No
Yes
No
Yes No
Year/Make
VIN
3
Yes
No
Yes
No
Yes No
Year/Make
VIN
4
Yes
No
Yes
No
Yes No
Year/Make
VIN
5
Yes
No
Yes
No
Yes No
Year/Make
VIN
6
Yes
No
Yes
No
Yes No
Year/Make
VIN
7
Yes
No
Yes
No
Yes No
Year/Make
VIN
8
Yes
No
Yes
No
Yes No
Year/Make
VIN
9
Yes
No
Yes
No
Yes No
Year/Make
VIN
10
Yes
No
Yes
No
Yes No
Year/Make
VIN
Comments :
HSMV-84015 S (Rev. 08/02)
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