Dmv Vehicle Removal Certificate Form PDF Details

In the realm of vehicle management and legal compliance, the DMV Vehicle Removal Certificate form, known officially as VSA 40 (revised on 11/10/2017), emerges as a vital document. This form finds its utility for individuals, businesses, or government entities, acting through themselves or their authorized agents, when they aim to document the removal, disposition, or both, of a motor vehicle, trailer, or manufactured home under their possession. Its comprehensive design encapsulates sections requiring detailed information about the vehicle—including its year, make, model, and identification number—as well as personal details of the individual or entity in possession. Further, it entails sections for towing company information, vehicle disposition intentions, and, if applicable, details on sales or transfers to demolishers or scrap metal processors. Designed with stringent adherence to Virginia's motor vehicle laws, it mandates signatories to affirm the truthfulness and accuracy of the information provided under penalty of perjury, emphasizing the legal responsibility and implications of falsification. Encompassing instructions for both manual and electronic reporting of vehicle dispositions to the DMV, this form not only ensures compliance with state vehicle laws but also aids in the meticulous tracking and responsible management of vehicle end-of-life processes.

QuestionAnswer
Form NameDmv Vehicle Removal Certificate Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesvsa 40, va vehicle removal form, virginia dmv vsa 40 form, va dmv 40

Form Preview Example

DATE (mm/dd/yyyy)
Is the vehicle currently registered? YES NO
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)

VEHICLE REMOVAL CERTIFICATE

VSA 40 (11/10/2017)

Purpose: This form is used by any person (individual, business, government; see VA Code §1-230) or their authorized agent(s) to track and record the removal and/or disposition of a motor vehicle, trailer or manufactured home in their possession.

Instructions: Complete and submit this form following the instructions on the back of the form.

1. VEHICLE/TRAILER/MANUFACTURED HOME INFORMATION

VEHICLE YEAR

VEHICLE MAKE

VEHICLE MODEL

VEHICLE IDENTIFICATION NUMBER (VIN)

VEHICLE LOCATION

CITY

STATE

VA

ZIP CODE

VEHICLE TYPE

 

AUTO

 

MANUFACTURED HOME

 

MOTORCYCLE

 

TRAILER

 

TRUCK

 

OTHER _________________

 

 

 

 

 

 

FULL NAME OF PERSON/AUTHORIZED AGENT IN POSSESSION OF VEHICLE

 

 

 

 

TELEPHONE NUMBER

ADDRESS OF PERSON/AUTHORIZED AGENT IN POSSESSION OF VEHICLE CITY

STATE

ZIP CODE

I certify and affirm that all information presented in this section is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

SIGNATURE OF PERSON/AUTHORIZED AGENT IN POSSESSION OF VEHICLE

DATE (mm/dd/yyyy)

 

 

2. TOWING COMPANY INFORMATION AND CERTIFICATION

The vehicle described →

LICENSED VEHICLE REMOVER'S COMPANY NAME

VRO CERTIFICATE NUMBER (or tow truck plate number)

above was released to

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

CITY

 

STATE

ZIP CODE

 

 

 

 

 

 

OPERATOR NAME (print)

TOWING COMPANY REPRESENTATIVE NAME (print) (if different than operator)

I certify and affirm that all information presented in this section is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

TOWING COMPANY REPRESENTATIVE SIGNATURE

3. VEHICLE DISPOSITION

I certify and affirm that I have complied with all requirements of the Virginia Motor Vehicle law for the above vehicle, trailer, or manufactured home and am:

obtaining title in my name (signature required below), selling at auction (complete section 4), transferring to a demolisher or scrap metal processor. (complete section 5)

I further certify and affirm that all information presented in this section is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

SIGNATURE OF PERSON/AUTHORIZED AGENT IN POSSESSION OF VEHICLE

4. SALE OF ABANDONED VEHICLE (AVP) INFORMATION

The vehicle described →

PURCHASER NAME (print)

 

 

above was sold to

 

 

 

 

 

 

 

 

 

ADDRESS

 

CITY

STATE

ZIP CODE

 

 

 

 

 

PURCHASE PRICE

PURCHASE DATE (mm/dd/yyyy)

ONLINE AVP RECEIPT NUMBER (if applicable)

I certify and affirm that I have complied with all requirements of the Virginia Motor Vehicle law for the above abandoned vehicle, trailer or manufactured home and am eligible to transfer ownership to a third party. I further certify and affirm that all information presented in this section is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

SELLER SIGNATURE

DMV HQ USE ONLY

Is the vehicle identification number (VIN) on the customer service system (CSS)? YES

NO

If VIN is not on CSS, is Abandoned Vehicle Receipt attached?

 

YES

 

NO Has the vehicle been previously entered as demolished?

 

YES

 

NO

 

 

 

 

 

 

 

 

 

Is the vehicle recorded as stolen? YES

NO

VSA 40 (11/10/2017)

Page 2

5. DEMOLISHER/SCRAP METAL PROCESSOR INFORMATION AND CERTIFICATION

As provided under VA Code, I have transferred possession of the above described vehicle to the licensed demolisher or scrap metal processor listed below for the purpose of demolition or conversion to scrap.

INDIVIDUAL/AUTHORIZED AGENT SIGNATURE (Transferor)

VEHICLE TRANSFER DATE (mm/dd/yyyy)

DEMOLISHER/SCRAP METAL PROCESSOR COMPANY NAME (Transferee)

DEMOLISHER CERTIFICATE NUMBER

TELEPHONE NUMBER

CHECK ONE OF THE FOLLOWING OR STAMP THE BLANK SPACE BELOW WITH APPROVED MERCURY SWITCH STAMP:

The mercury switches have been removed from the vehicle, were previously removed from the vehicle, or the vehicle was not manufactured with mercury switches.

The mercury switches could not be removed from the vehicle because upon attempt it was determined removal of the switches would be impractical, unreasonable or unsafe.

I certify that the vehicle has been demolished/scrapped. I further certify and affirm that all information presented in this section is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.

DEMOLISHER/SCRAP METAL PROCESSOR REPRESENTATIVE SIGNATURE

DATE DEMOLISHED OR SCRAPPED (mm/dd/yyyy)

INSTRUCTIONS

Section 1: The person or authorized agent in possession of the vehicle, trailer or manufactured home completes the vehicle and applicant information, and signs.

Section 2: The licensed vehicle remover completes and signs this section if the vehicle is towed. DMV must receive the original VSA 40 form.

Section 3: The person or authorized agent in possession of the vehicle, trailer or manufactured home must indicate his or her intent to title, sell or transfer the vehicle, trailer or manufactured home for demolition.

Section 4: The person or authorized agent in possession of a vehicle, trailer, or manufactured home that has been processed using DMV's online Abandoned Vehicle Process (AVP), completes this section and provides the purchaser with the AVP receipt and the completed, signed VSA 40 for use in titling the vehicle unless transferred directly to a licensed demolisher (See Section 5).

Section 5: The person or authorized agent transferring possession of the vehicle, trailer or manufactured home to a licensed demolisher or scrap metal processor signs this section and transfers this form with the vehicle to the demolisher/scrap metal processor. The licensed demolisher or scrap metal processor completes this section to certify that the vehicle, trailer or manufactured home was demolished or scrapped. A license number, signature, date and telephone number are required.

Manual Reporting of Vehicle Disposition to DMV:

Licensed demolishers or scrap metal processors, who do not report vehicle disposition electronically per Va. Code §46.2-1608.2, return the original VSA 40 form and applicable documents as required to DMV at the following address: Virginia Department of Motor Vehicles

Data Integrity Room 516

Post Office Box 27412 Richmond, Virginia 23269-0001

NOTE: A copy of this VSA 40 form must be retained by the demolisher/scrap metal processor in accordance with the requirements in VA Code §46.2-1206.

Electronic Reporting of Vehicle Disposition to DMV:

Licensed demolishers or scrap metal processors who report vehicle disposition electronically to DMV per Va. Code §46.2-1608.2 shall retain the original VSA 40 form, proof of ownership document(s) and applicable DMV forms (as required), on file in a secure location for at least five years in accordance with the requirements in Va. Code §46.2-1206. These files are subject to inspection by law-enforcement.

COMMENTS (Use the area below to enter any additional information.)

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1. The va vehicle removal certificate usually requires specific information to be entered. Make certain the next blanks are complete:

dmv vsa 40 completion process outlined (portion 1)

2. Right after finishing this section, head on to the next step and enter the essential details in these fields - I certify and affirm that all, TOWING COMPANY REPRESENTATIVE, DATE mmddyyyy, VEHICLE DISPOSITION, I certify and affirm that I have, obtaining title in my name, selling at auction complete, transferring to a demolisher or, I further certify and affirm that, SIGNATURE OF PERSONAUTHORIZED, DATE mmddyyyy, SALE OF ABANDONED VEHICLE AVP, The vehicle described above was, ADDRESS, and PURCHASER NAME print.

Stage no. 2 in filling in dmv vsa 40

3. The third step is usually simple - complete all the fields in As provided under VA Code I have, INDIVIDUALAUTHORIZED AGENT, VEHICLE TRANSFER DATE mmddyyyy, DEMOLISHERSCRAP METAL PROCESSOR, TELEPHONE NUMBER, CHECK ONE OF THE FOLLOWING OR, The mercury switches have been, The mercury switches could not be, I certify that the vehicle has, DEMOLISHERSCRAP METAL PROCESSOR, DATE DEMOLISHED OR SCRAPPED, INSTRUCTIONS, Section The person or authorized, applicant information and signs, and Section The licensed vehicle to conclude this process.

Filling out part 3 of dmv vsa 40

4. Filling out COMMENTS Use the area below to is essential in this next part - make certain that you spend some time and fill out every field!

dmv vsa 40 writing process outlined (step 4)

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