Form Tc-451 - Original Complaint Report
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Motor Vehicle Enforcement Division
TC-451
210 North 1950 West • Salt Lake City, UT 84134
(801) 297-2600 •
Rev. 2/17
Original Complaint Report
Type of Complaint
MVED use only
Consignment violation
Fraud/forgery
Case number
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Contract issues
Misrepresentation
Assigned to
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Failure to deliver title/registration
Odometer discrepancy
Date of report
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Failure to payoff trade-in
Salvage violation
Failure to pay warranty company
Unlicensed dealership or salesperson
Financial problem
Other:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
PLEASE READ:
If you have filed a case with another law enforcement agency or the Division of Consumer Protection
involving this same incident, enter the case number and the name of the person working on your case. If
you have filed a case in civil court, please indicate that below.
• Name of agency
__ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Case #
_ __ ________ _ _ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Contact person
___ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Contact phone number
_ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Yes
No
• Case filed in civil court?
Court and docket number
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Complainant
Name
Home phone
Cell phone
Business phone
Drivers license number (if you are not a dealer)
Drivers license state
Dealer number (if you are a dealer)
Address
City
State
ZIP Code
Mailing address
City
State
ZIP Code
Suspect
Name
Home phone
Cell phone
Business phone
Address
City
State
ZIP Code
Dealer #
Location of offense (transaction)
_ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_____ _ _ _ _ __ __ __ __ ________ _ _ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Vehicle Purchased
Year
Make
Model
Color
VIN
Purchase price
Financed through
Date of purchase
Trade-In Vehicle
Y
ear
Make
Model
Color
VIN
Was title delivered?
Yes No
Amount of payoff
Bank or finance company
Be sure to complete BOTH sides of this complaint form.
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Parent category: Legal