DMV Release of Liability for Junked/Salvaged Vehicle
Owner's Full Name
Street Address
City
State
ZIP Code
Phone Number
Email Address
Vehicle Identification Number (VIN)
Year
Make
Model
License Plate Number
Transaction Date (Junked/Salvaged)
Junk/Salvage Facility Name (if applicable)
Facility Address
City
State
ZIP Code
Additional Comments
Owner's Signature
Date