Form Mvr 181 PDF Details

Form Mvr 181 is an important document for drivers in the state of California. It is used to report a traffic collision and contains detailed information about the incident. Drivers who are involved in a collision should complete this form as soon as possible and submit it to the Department of Motor Vehicles. Completing Form Mvr 181 accurately can help ensure that all necessary information is obtained after a traffic collision. Violating any part of this form can result in fines and other penalties.

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QuestionAnswer
Form NameForm Mvr 181
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnorth carolina mvr181, mvr 181 damage disclosure statement, north carolina form mvr 181, north carolina mvr 181

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MVR-181

(REV. 12/2011)

DAMAGE DISCLOSURE STATEMENT

Questions 1 & 4 apply only to five (5) model years old and newer.

Alterations or erasures void this form.

NOTICE TO SELLER:

STATE LAW REQUIRES THAT EVERY SELLER DISCLOSE TO THE BUYER IF HE/SHE KNOWS THE INFORMATION LISTED BELOW.

FAILURE TO DO SO MAY RESULT IN CIVIL AND/OR CRIMINAL LIABILITY.

NOTICE TO BUYER:

RETAIN THIS INFORMATION.

STATE LAW REQUIRES YOU TO DISCLOSE SIMILAR DAMAGE INFORMATION WHEN YOU SELL OR TRANSFER TITLE TO THIS VEHICLE.

Year

Make

Body Style

Vehicle Identification Number

1.Has this vehicle been damaged by collision or other occurrence to the extent that damages exceed 25% of its value at the time of the collision or other occurrence? (Applies to 5 Model Years old and newer)

If yes, list parts that were damaged. _______________________________________________________________

______________________________________________________________________________________________

2.Was this vehicle a salvage motor vehicle? (Applies to All Model Years)

If yes, in which state was it titled? _________________________________________________________

3.Is this vehicle a flood vehicle? (Applies to All Model Years)

4.Is this vehicle a recovered theft vehicle? (Applies to 5 Model Years old and newer)

If yes, list parts that were damaged. ______________________________________________________________

5.Has this vehicle been reconstructed? (Applies to All Model Years)

Yes No

Yes No

Yes No

Yes No

Yes No

As the Seller, I declare that the above information is true to the best of my knowledge.

SELLER’S SIGNATURE: _________________________________________

DATE: ___________________________________________________________

SELLER’S ADDRESS: ____________________________________________________________________________________________________________________

BUYER’S ACKNOWLEDGEMENT AND SIGNATURE: ___________________________________________________________________________________________

 

Damage Disclosure Definitions

NOTICE TO BUYER:

The ter five odel years shall e al ulated y ou ti g the odel year of the vehi le’s a ufa ture as the first odel year

Five (5) Model Years -

RETAIN THIS INFORMATION. STATE LAW REQUIRES YOU TO DISCLOSE SIMILAR DAMAGE INFORMATION WHEN YOU SELL OR TRANSFER TITLE and the current calendar year as the final model year.

TO THIS VEHICLE.

Flood Vehicle - A motor vehicle that has been submerged or partially submerged in water in the extent that damage to the body, engine, *See definitions on reverse side.

transmission, or differential has occurred.

Non-U.S.A. Vehicle - A motor vehicle manufactured outside of the United States and not intended by the manufacturer for sale in the United States.

Reconstructed Vehicle - A motor vehicle of a type required to be registered hereunder that has been materially altered from original construction due to removal, addition or substitution of new or used essential parts; and includes glider kits and custom assembled vehicles.

Salvage Motor Vehicle - Any motor vehicle damaged by collision or other occurrence to the extent that the cost of repairs to the vehicle and rendering the vehicle safe for use on the public streets and highways would exceed seventy-five percent (75%) of its fair retail market value, whether or not the motor vehicle has been declared a total loss by an insurer. Repairs shall include the cost of parts and labor; or a vehicle for which an insurance company has paid a claim that exceeds 75% of the fair market retail value. Fair market retail values shall be as found in the NADA Pricing Guide Book or other publications approved by the Commissioner.

Salvage Rebuilt Vehicle - A salvage vehicle that has been rebuilt for title and registration.

Junk Vehicle - A motor vehicle which is incapable of operation or use upon the highways and has no resale value except as a source of parts or scrap, and shall not be titled or registered.

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