Affidavit Of Vehicle Unavailability For Inspection (Page 2 of 3) in pdf

Affidavit Of Vehicle Unavailability For Inspection Page 2

ALBUQUERQUE / BERNALILLO COUNTY

VEHICLE POLLUTION MANAGEMENT PROGRAM

1500 Broadway Blvd. NE

Albuquerque, New Mexico 87102

Phone (505) 764-1110

Fax: (505) 764-1101

AFFIDAVIT OF VEHICLE UNAVAILABILITY

FOR INSPECTION

______________________________________,

request a time extension for vehicle emission testing on

the vehicle described below. This vehicle is not currently located in Bernalillo County and is, therefore,

unavailable for inspection under the provisions of Title 20, Chapter 11, Part 100 Motor Vehicle Inspection -

Decentralized.

VEHICLE: YEAR ________ MAKE _________ LICENSE PLATE #___________

VEHICLE IDENTIFICATION # (VIN) _____________________________________

This vehicle is unavailable due to:

________ Student

(37)

________ Military Duty

(38)

________ Temporary Employment

(39)

________ *Other

(40)

*(Provide brief explanation) _____________________________________________

I hereby swear and affirm, under penalty of perjury that the information included herein is true

and accurate.

Address ____________________________________ Phone No. _________________

City ______________________________ State _________________ Zip __________

Signature ________________________________________________

Subscribed and sworn to before me this _________ day of ___________, 20 _______.

Notary Signature and Seal _____________________________

My Commission Expires: ______________________________

Affidavit Of Vehicle Unavailability For Inspection Page 2