Vehicle Inspection Form Colorado

VEHICLE IDENTIFICATION NUMBER (VIN) AND ODOMETER INSPECTION FORM

STATE OF COLORADO | DEPARTMENT OF REVENUE

I. VEHICLE INFORMATION

This section must be completed by the vehicle owner or agent prior to inspection.

• Year: [___________]
• Make: [___________]
• Model: [___________]
• Vehicle Identification Number (VIN): [_________________________________]
• Body Style: [___________]
• Fuel Type: [___________]
• Color: [___________]
• Odometer Reading: [___________] Miles
• License Plate Number: [___________]
• State of Issuance: [___________]

II. OWNER/APPLICANT INFORMATION

• Full Legal Name: [__________________________________________________]
• Physical Address: [__________________________________________________]
• City: [___________] State: [___________] Zip: [___________]
• Phone Number: [___________________________]
• Email Address: [___________________________]

III. INSPECTOR CERTIFICATION

To be completed by a Colorado Law Enforcement Officer or a Licensed Colorado Motor Vehicle Dealer.

I, the undersigned, hereby certify that I have physically inspected the vehicle described above. I have verified the VIN and odometer reading and have confirmed that the information provided is accurate and corresponds to the physical vehicle present.

• Inspection Date: [____/____/20____]
• Name of Inspector: [__________________________________________________]
• Agency/Business Name: [__________________________________________________]
• License/Badge Number: [__________________________________________________]
• Business Address: [__________________________________________________]

Physical Inspection Verification:

• VIN is legible and appears untampered: [ ] Yes [ ] No
• Odometer is functional: [ ] Yes [ ] No

IV. AFFIDAVIT AND SIGNATURES

CERTIFICATION OF OWNER: I, the undersigned owner, certify under penalty of perjury in the second degree, as defined in Section 18-8-503, C.R.S., that the information provided herein is true and correct to the best of my knowledge and belief. I acknowledge that falsification of any information on this document may result in the denial of registration or revocation of title.

Signature of Owner: __________________________________________ Date: [____/____/20____]

CERTIFICATION OF INSPECTOR: I hereby certify that I have personally inspected the vehicle described above and verify that the VIN and odometer reading documented are accurate as of the date of inspection.

Signature of Inspector: __________________________________________ Date: [____/____/20____]

V. OFFICIAL OFFICE USE ONLY

• Form Reviewed By: [___________________________]
• Date Processed: [____/____/20____]
• County/Office ID: [___________________________]
• Notes: [__________________________________________________________________________]

This document serves as an official record for Colorado Department of Revenue motor vehicle titling and registration purposes. Ensure all fields are completed legibly to avoid processing delays.