Form Hsmv 82012 PDF Details

When dealing with situations where a vehicle, vessel, or mobile home needs to be officially removed from operation through a Certificate of Destruction in the state of Florida, the HSMV 82012 form serves as a crucial document. Issued by the Department of Highway Safety and Motor Vehicles Division of Motorist Services, this form is a necessary step for towing and storage companies to lawfully dispose of such properties. It encompasses various sections including owner/applicant identification, vehicle/vessel description, and certifications by the owner/applicant affirming the lawful sale due to non-payment of towing and storage charges. Moreover, the form requires a detailed odometer declaration and a law enforcement check to ensure the item has not been reported as stolen. Completing this form accurately is vital for tow/transport companies to acquire a Certificate of Destruction, essentially finalizing the process that bars the vehicle, vessel, or mobile home from being legally operational again. Additionally, for situations requiring a duplicate certificate due to loss or damage to the original, the form accommodates this need, ensuring compliance and a streamlined process for all parties involved. The comprehensive layout and requirements set by the HSMV 82012 form underscore its importance in regulating the proper disposal and legal cessation of use for vehicles and vessels in Florida.

QuestionAnswer
Form NameForm Hsmv 82012
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfl application certificate, noncurrent records storage destruction request form, towing certificate destruction, hsmv 82012 form

Form Preview Example

STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

DIVISION OF MOTORIST SERVICES

SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE

www.flhsmv.gov/offices/

APPLICATION FOR TOWING AND STORAGE CERTIFICATE OF DESTRUCTION

1

OWNER / APPLICANT IDENTIFICATION

Owner’s Name (Tow/Transport Company)

FEID Number

Email Address

Tow Company's Street Address

City

State

Zip

2

 

 

VEHICLE/VESSEL DESCRIPTION

 

 

 

Vehicle/Vessel/Mobile Home Identification Number

 

Year

 

Make

Color

 

Body

Weight

 

 

 

 

 

 

 

 

 

 

 

 

 

Previous State of Issue

 

Length (if applicable)

 

BHP/CC (if applicable)

Florida Title Number or FL#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

TYPE OF TOW

 

 

 

 

 

 

 

PUBLIC

 

 

 

 

 

 

PRIVATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

OWNER / APPLICANT’S CERTIFICATIONS

 

 

 

The Motor Vehicle/Vessel/Mobile Home described above was owned by ________________________________________________,

(Last Registered Owner of Record)

with a recorded lien to ___________________________________________________________________ and has been lawfully sold to

(Registered Lienholder of Record)

__________________________________________________ on ___________________, in a Non-Judicial State for enforcement

(Towing/Transport Company)(Date)

of a lien for towing and storage charges justly owing and unpaid since _____________________. Having followed all provisions of

(Impound Date)

Section 713.78 or 713.785, Florida Statutes, I understand that no sales tax is due and I certify that the vehicle/vessel/mobile home identification number shown on this application has been physically inspected by me, and is identical to the vehicle/vessel/mobile home identification number shown on the motor vehicle/vessel/mobile home.

I have made a diligent search and inquiry as to the registered owner, lienholder and insurance company without beneficial results. A good faith effort has been made as defined in Section 713.78 or 713.785, Florida Statutes.

I hereby certify that ownership information was unavailable within the seven (7) day period required by law and hereby certify that law enforcement was notified by this company after seven (7) days. Attached is a copy of the notice sent to law enforcement and a copy of the returned receipt showing the date or a copy of the acknowledged hand-delivered receipt signed by the law enforcement agency.

I hereby certify that the owner of the motor vehicle/vessel/mobile home described above has transferred the attached title over to our tow/transport company in lieu of paying the towing and storage charges. We understand this process will permanently relinquish our company's ability to place a wrecker operator's lien against the owner of this vehicle/vessel/mobile home.

If applying for a "duplicate" Certificate of Destruction, check this block:

I hereby certify that this company is the owner of the motor vehicle/vessel/mobile home described above and a Certificate of Destruction was issued in the company's name on ________________. I hereby certify that the Certificate of Destruction has been

lost or destroyed and request a duplicate Certificate of Destruction be issued. If the lost or missing Certificate of Destruction is located, it will be returned to the Department.

5

MOTOR VEHICLE ODOMETER DECLARATION

I/WE STATE THAT THIS 5 OR

6 DIGIT ODOMETER NOW READS

,

.XX (NO TENTHS) MILES DATE READ

________/________/________, AND I/WE HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE ODOMETER READING IS:

1. reflects ACTUAL MILEAGE.

2. is IN EXCESS OF ITS MECHANICAL LIMITS.

3.is NOT THE ACTUAL MILEAGE.

WARNING – ODOMETER DISCREPANCY

6

OWNER / APPLICANT’S SIGNATURE

In consideration of the foregoing and the attached evidence of ownership to the motor vehicle/vessel/mobile home described above, I request that the Certificate of Destruction be issued in the towing/transport company's name.

I hereby swear or affirm, under penalty of perjury, that this company owns the above-described motor vehicle/vessel/mobile home and I affirm under penalty of perjury that all of the foregoing information is true and correct. I further agree to defend the title against all claims. I further certify that I have made a physical inspection of the vehicle (when applicable) and have recorded the vehicle identification number, other identification information and the odometer reading in the spaces provided on this form.

Name of Tow/Transport Company _____________________________________________________________________________

Signature of Agent _____________________________ Printed Name of Agent: _________________________________________

HSMV 82012 (Rev. 06/13) S

www.flhsmv.gov

7 LAW ENFORCEMENT CHECK (Not Required if there is a Current Florida Title Record)

Date: ____________________ Vehicle/Vessel/Mobile Home Identification Number: ________________________________________

I hereby certify that I have physically verified the vehicle identification number shown above on the motor vehicle described on the reverse side of this form and find the numbers to be the same. I further certify that I have made inquiry in the Florida Crime Information Center (FCIC) and the National Crime Information Center (NCIC) and find that the vehicle identification number shown above has not been reported as stolen.

I hereby certify that I have made inquiry in the Florida Crime Information Center (FCIC) and the National Crime Information Center (NCIC) and find that the identification number for the vessel or mobile home shown above has not been reported as stolen.

Agency Name: ___________________________________________________________ Badge Number: ______________________

Law Enforcement

Officer's Signature: _________________________________ Printed Name: ___________________________________________

TOWING AND STORAGE CHECKLIST FOR CERTIFICATE OF DESTRUCTION

You should review section 713.78 and 713.785, Florida Statutes, or DMS Procedure TL-26 prior to making application for a Certificate of Destruction.

FLORIDA RECORD:

OUT -OF-STATE:

HSMV 82012

Notice of claim of lien including:

Statement of possession by the tow company

HSMV 82012

HSMV 82042, or form HSMV 82012 (section 7)

Verification as to title/lien status OR affidavit stating previous state "UNKNOWN" and a good faith effort has been made.

That a lien is claimed and subject to enforcement, as provided by Section 713.78, Florida Statutes

That owner or lienholder has the right to a hearing

Description of vehicle/vessel, year, make and vehicle/vessel identification number

That charges have accumulated (total amount owed, itemized)

Name of person who authorized the tow

Signature of authorized agent for the towing company

Date of the Notice of Claim of Lien and date of the towing

Tow company's complete name, address and telephone number

That any motor vehicle/vessel which remains unclaimed, for which towing and storage charges remain unpaid, may be sold free of all prior liens after 35 days if the vehicle or vessel is more than 3 years of age or after 50 days, if the vehicle or vessel is 3 years old or less.

Notice of sale including: (this information may be included in the Notice of Claim of Lien)

Date, time and location of sale

Location of vehicle/vessel

Description of vehicle/vessel, year, make and vehicle/vessel identification number

Date of towing

Tow company's complete name, address and telephone number

Total charges for towing and storage (itemized)

Signature of authorized agent for towing company

Copy of newspaper advertisement, showing the name of the newspaper and date the advertisement was published, including:

Date, time and location of sale

Description of vehicle/vessel, year, make and vehicle/vessel identification number

Proof of Notification to law enforcement (if applicable), along with a copy of the letter and proof verifying a record check of NMVTIS.

Copy of police report, impound storage receipt or a copy of the tow ticket (for private tow) or trip sheet, if previous state where vehicle/vessel was registered is "UNKNOWN."

Proof of reporting to NMVTIS (if applicable). Not applicable to mobile homes.

Certificate of Destruction fee

CHECK LIST FOR CERTIFICATE OF DESTRUCTION (WHEN OWNER IS TRANSFERRING TITLE FOR TOWING & STORAGE CHARGES)

Florida or out of state title

HSMV 82012 (if title is out of state, section 7 of this form must be completed)

Certificate of Destruction fee

A copy of the trip sheet or tow ticket

Proof of reporting to NMVTIS (if applicable)

HSMV 82012 (Rev. 06/13) S

www.flhsmv.gov

How to Edit Form Hsmv 82012 Online for Free

Once you open the online PDF editor by FormsPal, you may fill out or modify hsmv 82012 form here and now. Our editor is consistently developing to grant the very best user experience possible, and that is thanks to our commitment to constant improvement and listening closely to customer comments. Getting underway is easy! What you need to do is adhere to the following simple steps down below:

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Be mindful when completing this form. Ensure that all required blank fields are filled in correctly.

1. First of all, once filling out the hsmv 82012 form, start in the page that has the subsequent fields:

Filling out part 1 of towing certificate

2. After this part is completed, proceed to enter the suitable details in all these - on in a NonJudicial State for, I have made a diligent search and, I hereby certify that the owner of, If applying for a duplicate, I hereby certify that this company, MOTOR VEHICLE ODOMETER DECLARATION, IWE STATE THAT THIS AND IWE, is IN EXCESS OF ITS MECHANICAL, reflects ACTUAL MILEAGE, DIGIT ODOMETER NOW READS, is NOT THE ACTUAL MILEAGE, WARNING ODOMETER DISCREPANCY, XX NO TENTHS MILES DATE READ, OWNER APPLICANTS SIGNATURE, and In consideration of the foregoing.

towing certificate completion process clarified (step 2)

3. This 3rd step should be pretty straightforward, In consideration of the foregoing, and wwwflhsmvgov - each one of these empty fields has to be filled out here.

wwwflhsmvgov, In consideration of the foregoing, and wwwflhsmvgov in towing certificate

4. To go forward, this part involves typing in a couple of empty form fields. These comprise of LAW ENFORCEMENT CHECK, Not Required if there is a Current, Date VehicleVesselMobile Home, I hereby certify that I have, I hereby certify that I have made, Agency Name Badge Number Law, TOWING AND STORAGE CHECKLIST FOR, You should review section and, OUT OFSTATE HSMV HSMV or form, Notice of claim of lien including, Statement of possession by the tow, That a lien is claimed and subject, and That owner or lienholder has the, which are essential to carrying on with this particular form.

towing certificate writing process shown (portion 4)

It's easy to make errors while filling in your I hereby certify that I have, consequently you'll want to take another look before you'll finalize the form.

5. Now, the following last segment is what you will have to finish prior to finalizing the form. The blank fields in question include the next: That owner or lienholder has the, Signature of authorized agent for, Date of the Notice of Claim of, That any motor vehiclevessel which, Notice of sale including this, Date time and location of sale, Description of vehiclevessel year, Date of towing, Tow companys complete name address, Total charges for towing and, Signature of authorized agent for, Copy of newspaper advertisement, Date time and location of sale, Description of vehiclevessel year, and Proof of Notification to law.

Simple tips to fill in towing certificate part 5

Step 3: When you have looked once more at the details in the fields, simply click "Done" to conclude your form. Download the hsmv 82012 form as soon as you subscribe to a free trial. Conveniently get access to the pdf form inside your personal cabinet, along with any edits and changes being conveniently kept! We don't sell or share the information you type in whenever dealing with documents at our site.