Transcription of VIN Verfication Form2 - Connecticut
1 Manufacturer s or Importers Certificate of OriginDepartment of Motor VehiclesSTATE OF CONNECTICUTV ehicle ModelVehicle Manufacturer (signature)Vehicle Identification Number Verification FeeVehicle Model YearOdometer Plate NumberPlate State(Date)Date of Verification INSPECTOR SIGNATURED ealer/Repairer License Number Test Center AddressThe manufacturer s vehicle identification number, listed above, has not been modified, altered, or removed from the vehicle, and the complete vehicle identification number has been examined in the two locations listed below(1):Location 1:(2)Foreign Registration Documents ( grey market vehicles) must be referred to the Department of Motor Vehicles. Inspector Number Verifying Inspector Name Vehicle Identification Number (VIN)Verification Form Test Center Number Vehicle Body TypeTEST CENTER INFORMATIONK190 CTVIP42013 INSPECTOR INFORMATIONL ocation 2: The Vehicle Identification Number listed above MUST correspond to one of the following documents:(2) (1)Some vehicles may only have one verifiable VIN location, if so acknowledge 'Location 2' with "One Verifiable VIN Location".
2 Test Center Name VEHICLE INFORMATIONThis verification of the Vehicle Identification Number DOES NOT constitute evidence of the vehicle s safety status , registration or of TitleRegistration DocumentThis information provided to the Commissioner of Motor Vehicles herein is subscribed by me the undersigned, under penalty of false statement, in accordance with the provisions of Section 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make a statement which I do not believe to be true, with the intent to mislead the Commissioner, I will be subject to prosecution under the above cited VIN NUMBERThe vehicle identification number, listed on this form, cannot be verified on the vehicle presented for verification. The VIN number is either missing, has been modified, altered, or removed from the vehicle.
3 The vehicle must be inspected by the Department of Motor :CT188 YWAM ario Daponte28 Belmose Ave, Rocky Hill, CT 064572004 Sedan (4 Doors)ApplusMaximamdaponte$ VIN Tag06/21/2013 Truck Li
