In the realm of vehicular and vessel management, the Certificate of Destruction is a crucial document that holds significant weight in ensuring the regulated decommissioning of such assets. Issued by the State of Florida Department of Highway Safety and Motor Vehicles Division of Motor Vehicles, this form serves as a testament that a vehicle or vessel has met its end through means such as crushing, dismantling, or cutting into pieces. Highlighting essential details like the Vehicle/Vessel Identification Number, make, model, and the odometer status at the time of destruction, this certificate ensures a transparent record of the asset's final state. A noteworthy aspect of the process is the clear stipulation that once a Certificate of Destruction is issued, the department will no longer issue any Certificate of Title for the said vehicle or vessel, underscoring the irreversible nature of this action. The form also outlines the procedure for the transfer of ownership from the current owner to a buyer, specifying that the transaction is conducted under penalty of perjury, thereby emphasizing the legal implications and the importance of accuracy in the documentation provided. The certificate further requires information about the selling price and sales tax collected, if applicable, ensuring a comprehensive record of the transaction. This document, mandatory to be kept in files for three years by the company facilitating the destruction, is a critical step in the lifecycle of vehicles and vessels in Florida, ensuring that the end of their service is documented and processed in accordance with state regulations.
| Question | Answer |
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| Form Name | Certificate Of Destruction Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | FLORIDA, certificate of destruction, certificate of destruction florida, 1ificate |
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STATE OF FLORIDA |
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DEPARTMENT OF H1GHWAY SAFETY AND MOTOR VEHICLES |
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DIVISION OF MOTOR VEHICLES |
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T# |
525963284 |
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Neil Kirkman Building· Tallahassee, Florida 32399 |
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B# |
66099 |
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CERTIFICATE OF DESTRUCTION |
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VEHlCLE'JVESSEL DESCRIPTION |
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VehicleNesselldenlification |
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Make |
Model |
Body |
Florida Title or Florida Number |
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BROWARDTEST |
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CHEV |
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2D |
83282125 |
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ODOMETER STATUS |
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TYPE OF TOW |
DATE OF |
ISSUE |
150,000 |
MILES |
09/30110 |
ACTUAL MILEAGE |
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PUBL |
11/30/2010 |
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OWNER (TOW/INSURANCE COMPANY):
SAMMY SAMPLE TOW SERVICE 2900 APALACHEE PKWY TALLAHASSEE. FL 32399
NOTE: When a Ce.1ificate of Destruction has been issued, the Dep3J1ment will refuse issuance of any Certificate of Title for that vehicle/vessel.
FIRST ASSIGNMENT For value received, this vehiclelvessel described above is certified, under penallies of perjury, to be free of all liens and is hereby transferred 10:
Buyer's Name: |
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Buyer's Sales Tax Registration #: |
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Buyer's Address: |
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Street |
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City |
State |
Zip |
Seller's Company Name: |
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Seller's Signature: |
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Seller's Printed Name: |
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Sales Tax Reg. No: |
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Date of Sale: |
Selling Price: $ |
Sales Tax Collected: $ |
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ISECOND ASSIGNMENT IFor value received, this vehicle/vessel described above is certified, under penalties of perjury, to be free of all liens and is hereby transferred to:
Buyer's Name: |
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Buyer's Sales Tax Registration #: |
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Buyer's Address: |
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Street |
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City |
State |
Zip |
Seller's Company Name: |
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Seller's Signature: |
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Seller's Printed Name: |
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Sales Tax Reg. No: |
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Date of Sale: |
Selling Price: $ |
Sales Tax Collected: $ |
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CERTIFICATE |
OF DESTRUCTION |
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Under penalties of perJury,I hereby certify that the vehicle/vessel described above has been destroyed by crushing, dismantling or cutting into several sections. |
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I understand this form is to be kept in my files for three (3) years. |
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Company Name: |
Date: |
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Agent's Printed Name: |
Agent's Signature: |
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NOTE: Please Print or Type, If buyer has Tax Registration Number, the Selling Price and Sales Tax Collected blocks 3J'enot applicable.
Original - Issued to Tow/Insurance |
Company, but transferred and given to new owner |
Copy - Tow/Insurance Company |
H5MV 82013 (REV. 02106)5
ORIGINAL