Certificates of destruction are an important part of the records management process. A certificate of destruction is a document that confirms that a record has been destroyed in accordance with the requirements of your organization. The certificate of destruction also confirms that the destruction was performed by an authorized individual or entity. In this blog post, we will discuss the importance of certificates of destruction and how to complete one.
| 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 |
Number |
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