DAMAGE/SALVAGE DISCLOSURE STATEMENT
North Dakota Department of Transportation, Motor Vehicle
SFN 18609 (8-2019)
MOTOR VEHICLE DIVISION
ND DEPT OF TRANSPORTATION 608 E BOULEVARD AVE BISMARCK ND 58505-0780 Telephone (701) 328-2725
Fax (701) 328-1487 Website: https://dot.nd.gov
This form MUST be completed by the transferor (seller) for all vehicles less than nine (9) model years old.
This form MUST be signed by the transferor (seller), given to and signed by the transferee (buyer), and accompany the application for title.
Vehicle Identification Number (VIN)
Section 1: NDCC 39-05-17.2
Within the past eight (8) years, has this vehicle sustained body or structural damage from a vehicular crash or accident, including loss by fire,
vandalism, weather, or submersion in water, resulting in damage to the motor vehicle? |
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Yes* |
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No |
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The term damage does not include body or structural modifications, normal wear and tear, glass damage, hail damage, or items of normal maintenance and repair.
*If yes is checked, sections 2 & 3 must be completed.
Section 2: NDCC 39-05-20.2 & 37-09-01-02
If vehicle has sustained damage, please answer the following question:
Do the damages equal or exceed the greater of $10,000 or twenty-five percent (25%) of the pre-damage retail value of the motor vehicle as
determined by the National Automobile Dealers Association official used car guide? |
Yes |
No |
Section 3: NDCC 39-05-20.2 & NDAC 37-09-01-02
If the vehicle has sustained damage, please answer the following question:
Do the damages exceed seventy-five percent (75%) of its retail value? |
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Yes* |
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No |
3A. *If you answered yes, please check the box below that best describes your situation.
Damage occurred in a single occurrence while I owned the vehicle.
I acquired the vehicle with unrepaired damage.
Damage occurred prior to my ownership and I acquired it in a repaired condition.
Other - Must explain:
3B. Type of Damage: |
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Collision |
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Weather |
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Theft |
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Interior |
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(check all that apply) |
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Water |
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Vandalism |
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Fire |
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Under Carriage |
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Other |
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Explanation of Damage:
Any person who makes a false statement on this form is guilty of a Class A Misdemeanor.
Section 4
Name of Transferor (Seller) |
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Daytime Telephone Number |
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Mailing Address |
City |
State |
ZIP Code |
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Signature of Transferor (Seller) |
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Date |
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Section 5 |
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Legal Name of Transferee (Buyer) |
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Daytime Telephone Number |
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Mailing Address |
City |
State |
ZIP Code |
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Signature of Transferee (Buyer) |
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Date |
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SFN 18609 (8-2019)
Page 2 of 2
INSTRUCTIONS FOR COMPLETING DAMAGE/SALVAGE DISCLOSURE STATEMENT
Section 1
The seller must disclose if there has been damage* to the vehicle within the past 8 years by checking YES or NO to the question.
If YES, proceed to Sections 2 & 3.
*Damage is defined as body or structural damage from a vehicular crash or accident including loss by fire, vandalism, weather, or submersion in water, resulting in damage to the motor vehicle. The term damage does NOT include body or structural modifications, normal wear and tear, glass damage, hail damage, or items of normal maintenance and repair.
Section 2
The seller must disclose if damages* equal or exceed the greater of $10,000 or twenty-five percent (25%) of the pre-damage retail value of the motor vehicle by checking YES or NO to the question.
*The amount of damage to a motor vehicle is determined by adding the retail value of all labor, parts, and materials used in repairing the damage. See NDCC 39-05-17.2 for further information on calculating the Assessed Damage of a vehicle.
DAMAGE DISCLOSURE FORMULA
1.Calculate 25% of the retail value of the vehicle at the time the vehicle was damaged.
2.Which is the higher amount 25% of the retail value of the vehicle or $10,000?
3.What is the amount of the assessed damage?
4.The assessed damage amount must be greater than the higher amount from step 2 to be a damaged vehicle.
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EXAMPLE 1 |
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EXAMPLE 2 |
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1. |
$15,000 (retail value) X 25% = $3,750 |
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$50,000 |
(retail value) X 25% = $12,500 |
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2. |
$3,750 OR $10,000 = $10,000 is higher |
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$12,500 |
OR $10,000 = $12,500 is higher |
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3. |
Assessed damage is $7,000 |
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Assessed damage is $13,000 |
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4. |
Check NO on damage disclosure form |
4. |
Check YES on damage disclosure form |
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Section 3
The seller must disclose if the damages* exceed seventy-five percent (75%) of the motor vehicles retail value by checking YES or NO to the question.
If YES, seller must answer Sections 3a. & 3b.
*Vehicles damaged in excess of 75% may not be operated on ND highways unless they have been reconstructed and inspected by a business that is registered with the Secretary of State, is in good standing, and offers motor vehicle repairs to the public. (SFN 2486 Certificate of Vehicle Inspection) The business completing the inspection may not be the same business that reconstructed the vehicle. If a vehicle has been reconstructed, a certificate of title will be issued with a "previously salvaged" brand status. Salvage requirements apply to all model year vehicles and all brands must be carried forward regardless of the age of the vehicle.
Section 3a
The seller must select one of the options which best describes their ownership of the vehicle in regards to the disclosed damage. Example of "Other": Title already branded for the damage disclosed above.
Section 3b
The seller must select all that apply which best describes the type of damage to the vehicle and briefly explain. Example of "Explanation of Damage": Hit a deer.
Section 4
Seller information to be completed in full with seller signing and dating the form.
Section 5
The buyer is only required to complete Section 5 if YES has been answered to any of the questions completed by the seller.
