Inventory of Component Parts Purchased/Affidavit Bill of Sale ......Inventory of Component Parts...
1
Inventory of Component Parts Purchased/ Affidavit Bill of Sale Seller Information First Name (or Entity Name) Middle Name Last Name Suffix (if any) Address City State Zip Driver License State and Number Age Sex License Plate State and Number of Delivery Vehicle Date of Purchase or Delivery Federal Taxpayer Identification Number (or Dealer License Number, if applicable) Purchasing Dealer Information Name of Dealer Dealer License Number Address City State Zip Component Part Information Part 1 Vehicle Identification Number (if available) Year Make Model Name/Description of Component Part Color Size Type of Material (if applicable) Part 2 Vehicle Identification Number (if available) Year Make Model Name/Description of Component Part Color Size Type of Material (if applicable) Part 3 Vehicle Identification Number (if available) Year Make Model Name/Description of Component Part Color Size Type of Material (if applicable) Part 4 Vehicle Identification Number (if available) Year Make Model Name/Description of Component Part Color Size Type of Material (if applicable) Certification – State law makes falsifying information a third degree felony I certify all component part(s) were purchased by the purchaser from the seller on the date as shown above. Signature of Seller/Seller’s Agent Printed Name (Same as Signature) Date Signature of Dealer or Authorized Agent Printed Name (Same as Signature) Date Affidavit Bill of Sale – if applicable I affirm the component part(s) listed above do not have a vehicle identification number associated with them, or the vehicle identification number of the vehicle from which the component part was removed is not available. Signature of Dealer or Authorized Agent Printed Name (Same as Signature) Date NOTARY STAMP HERE Before me, a notary public, on this day personally appeared , known to me to be the person whose name is subscribed on this document, and being by me first duly sworn, declared that the statements herein contained are true and correct. State of Texas, County of Notary Public’s Signature Date VTR-207 Rev 05/20 Form available online at www.TxDMV.gov Page 1 of 1
Transcript of Inventory of Component Parts Purchased/Affidavit Bill of Sale ......Inventory of Component Parts...
-
Inventory of Component Parts Purchased/ Affidavit Bill of Sale
Seller Information First Name (or Entity Name) Middle Name Last Name Suffix (if any)
Address City State Zip
Driver License State and Number Age Sex License Plate State and Number of Delivery Vehicle
Date of Purchase or Delivery Federal Taxpayer Identification Number (or Dealer License Number, if applicable)
Purchasing Dealer Information Name of Dealer Dealer License Number
Address City State Zip
Component Part Information
Part
1 Vehicle Identification Number (if available) Year Make Model
Name/Description of Component Part Color Size Type of Material (if applicable)
Part
2 Vehicle Identification Number (if available) Year Make Model
Name/Description of Component Part Color Size Type of Material (if applicable)
Part
3 Vehicle Identification Number (if available) Year Make Model
Name/Description of Component Part Color Size Type of Material (if applicable)
Part
4 Vehicle Identification Number (if available) Year Make Model
Name/Description of Component Part Color Size Type of Material (if applicable)
Certification – State law makes falsifying information a third degree felony I certify all component part(s) were purchased by the purchaser from the seller on the date as shown above.
Signature of Seller/Seller’s Agent Printed Name (Same as Signature) Date
Signature of Dealer or Authorized Agent Printed Name (Same as Signature) Date
Affidavit Bill of Sale – if applicable I affirm the component part(s) listed above do not have a vehicle identification number associated with them, or the vehicle identification number of the vehicle from which the component part was removed is not available.
Signature of Dealer or Authorized Agent Printed Name (Same as Signature) Date
NOTARY STAMP HERE
Before me, a notary public, on this day personally appeared , known to me to be the person whose name is subscribed on this document, and being by me first duly sworn, declared that the statements herein contained are true and correct.
State of Texas, County of Notary Public’s Signature Date VTR-207 Rev 05/20 Form available online at www.TxDMV.gov Page 1 of 1
http://www.txdmv.gov/
First Name or Entity Name Middle Name Last Name Suffix if any: Address City State Zip: Driver License State and Number: Age: Sex: License Plate State and Number of Delivery Vehicle: Date of Purchase or Delivery: Federal Taxpayer Identification Number or Salvage Vehicle Dealer License Number if applicable: Address City State Zip_2: Vehicle Identification Number if available: Year: Make: Model: NameDescription of Component Part: Color: Size: Type of Material if applicable: Vehicle Identification Number if available_2: Year_2: Make_2: Model_2: NameDescription of Component Part_2: Color_2: Size_2: Type of Material if applicable_2: Vehicle Identification Number if available_3: Year_3: Make_3: Model_3: NameDescription of Component Part_3: Color_3: Size_3: Type of Material if applicable_3: Vehicle Identification Number if available_4: Year_4: Make_4: Model_4: NameDescription of Component Part_4: Color_4: Size_4: Type of Material if applicable_4: Date: Date_2: Date_3: State of Texas County of: Date_4: Printed Name 2: Printed Name: Printed Name3: Person appearing: Name of Dealer: Dealer License Number:
