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

Affidavit Of Vehicle Unavailability For Inspection Page 3

THIS FORM MUST BE COMPLETED AND SIGNED BY AN MVD

AGENT, LAW ENFORCEMENT OFFICER OR

MILITARY/CAMPUS POLICE AS PROOF OF VEHICLE

UNAVAILABILITY

STATE OF NEW MEXICO - MOTOR VEHICLE DIVISION

AFFIDAVIT OF V.I.N. INSPECTION

In or Out-of-State Inspection

Vehicle inspections must be conducted by an authorized New Mexico (or other state) MVD

Agent, employee or full time law enforcement officer.

Name of Registered Owner

at Time of Inspection

VEHICLE INFORMATION (Complete where applicable)

YEAR

MAKE

MODEL

TYPE

STATE REGISTERED

Vehicle Identification Number

Vehicle Odometer Reading

Vehicle License Plate No.

Vehicle Location

State

County

City

I CERTIFY THAT THE IDENTIFICATION NUMBER RECORDED HEREIN IS ON THE VEHICLE

DESCRIBED ABOVE CLAIMED TO BE OWNED BY THE PERSON OR BUSINESS INDICATED, THAT I

HAVE CONDUCTED A VISUAL INSPECTION ONLY AND THAT I AM NOT INVOLVED IN OR

RESPONSIBLE FOR ANY OTHER ACTIVITIES OR TRANSACTIONS RELATED TO THIS VEHICLE.

Inspector’s Printed Name

Inspector’s Signature

Badge or ID No.

Date

Agency / Dealer Name

State

Please return this affidavit with supporting documentation to the

City of Albuquerque [Fax (505) 764-1101] or mail to:

City of Albuquerque Vehicle Pollution Management Program

1500 Broadway NE

Albuquerque, New Mexico 87102

***IF YOU HAVE ANY QUESTIONS CONTACT OUR OFFICE AT (505) 764-1110***

Affidavit Of Vehicle Unavailability For Inspection Page 3