Used Motor Vehicle Alteration Or Damage Inspection Form

Seller Name and Contact Information: ______________________________________________________________ Year__________Make_________________________Model_______________________Color____________ VIN_____________________________________________Odometer___________________________________ None Noted Yes Describe, if yes (attach separate page if needed). DISCOVERED SAFETY ISSUES ____ ____ ____________________________________ CHASSIS OR STRUCTURAL DAMAGE ____ ____ ___________________________________________ NON INDUSTRY-STANDARD REPAIR ____ ____ ___________________________________________ UNREPAIRED DAMAGE ____ ____ ___________________________________________ CHASSIS INSPECTION None Noted Yes Location – Details, if yes Frame/Unibody Repair/Welds ____ ____ ___________________________________________ Frame Machine Pinch Marks ____ ____ ___________________________________________ Other ____ ____ ___________________________________________ BODY PANEL INSPECTION None Noted Yes Location – Details, if yes Replaced Body Panels ____ ____ ___________________________________________ Damaged/Repaired Body Panels ____ ____ ___________________________________________ Uneven Body Panel Gaps ____ ____ ___________________________________________ Other ____ ____ ___________________________________________ PAINT INSPECTION None Noted Yes Location – Details, if yes Difference in Paint Color/Texture ____ ____ ___________________________________________ Uneven Paint Thickness ____ ____ ___________________________________________ Aftermarket Overspray/Mask-lines ____ ____ ___________________________________________ Other ____ ____ ___________________________________________ Was motor vehicle placed on a lift to inspect chassis?__Yes__No Was a paint mil thickness gauge used to measure paint thickness?__Yes__No Good faith estimate whether discovered prior alteration/damage/repair cost exceeds six percent of sales Price:__Yes__No Cost of Inspection: $_________________ Date of Inspection:___________________________ Inspector Name:______________________________________ Inspector Contact Information:____________________________________________________________________ Inspector Signature:____________________________________________ Other Inspection Comments: (Note discovered damage, alterations or repairs not otherwise disclosed on this form.) PRIOR ALTERATION/DAMAGE/REPAIR INSPECTION IS BASED ON GOOD FAITH OBSERVATION, MINIMAL DISASSEMBLY AND WITHOUT USE OF COMPUTERIZED MEASURING SYSTEM(S). See NMAC 12.2.14.1, et seq., (NOT A WARRANTY.)