Fillable Form 7: AFFIRMATION SUPPORTING SALVAGE CERTIFICATE 2IFHRIWKH6HFUHWDU\RI6WDWH KLVIRUPPXVWDFFRPSDQ\DOO6DOYDJH&HUWLFDWHVIRUZKLFKD&HUWLFDWHRI7LWOHLVUHTXHVWHG (Illinois Secretary of State)

Fill Online, Printable, Fillable, Blank Form 7: AFFIRMATION SUPPORTING SALVAGE CERTIFICATE 2IFHRIWKH6HFUHWDU\RI6WDWH KLVIRUPPXVWDFFRPSDQ\DOO6DOYDJH&HUWLFDWHVIRUZKLFKD&HUWLFDWHRI7LWOHLVUHTXHVWHG (Illinois Secretary of State) Form

Use Fill to complete blank online ILLINOIS SECRETARY OF STATE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 7: AFFIRMATION SUPPORTING SALVAGE CERTIFICATE 2IFHRIWKH6HFUHWDU\RI6WDWH KLVIRUPPXVWDFFRPSDQ\DOO6DOYDJH&HUWLFDWHVIRUZKLFKD&HUWLFDWHRI7LWOHLVUHTXHVWHG (Illinois Secretary of State)

On average this form takes 14 minutes to complete

The Form 7: AFFIRMATION SUPPORTING SALVAGE CERTIFICATE 2IFHRIWKH6HFUHWDU\RI6WDWH KLVIRUPPXVWDFFRPSDQ\DOO6DOYDJH&HUWLFDWHVIRUZKLFKD&HUWLFDWHRI7LWOHLVUHTXHVWHG (Illinois Secretary of State) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 54 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Illinois Secretary of State forms online.

BROWSE ILLINOIS SECRETARY OF STATE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
2IÀFHRIWKH6HFUHWDU\RI6WDWH
AFFIRMATION SUPPORTING SALVAGE CERTIFICATE
7
KLVIRUPPXVWDFFRPSDQ\DOO6DOYDJH&HUWLÀFDWHVIRUZKLFKD&HUWLÀFDWHRI7LWOHLVUHTXHVWHG
6WDWHRI,OOLQRLV
&RXQW\RIBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
Complete Section A or B:
A.
5HEXLOGHUVWDWHVWKDWRISDUWVOLVWHGRQWKHUHYHUVHVLGHRIWKLVDIÀUPDWLRQRQO\WKHIROORZLQJKDYHEHHQFKDQJHG
Type of Part VIN Year Make Acquired From
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB BBBB BBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBB
5HEXLOGHUSHUVRQDOO\UHEXLOWWKH
YHKLFOHRUSHUVRQDOO\VXSHUYLVHGLWVUHEXLOGLQJ5HEXLOGHUSHUVRQDOO\LQVSHFWHG
WKHFRPSOHWHGYHKLFOHDQGLWFRPSOLHVZLWKDOOVDIHW\UHTXLUHPHQWVVHWIRUWKLQWKH,OOLQRLV&RPSLOHG6WDWXWHV
&KDSWHUDQGDQ\UHJXODWLRQVSURPXOJDWHGWKHUHXQGHUE\WKH6HFUHWDU\RI6WDWH
B.
5HEXLOGHUDIÀUPVWKDWQRHVVHQWLDOSDUWVKDYHEHHQUHPRYHGUHSODFHGRUGDPDJHGE\ÁRRGDQGWKDW
FRPSOHWLRQRIWKLVDIÀUPDWLRQSURYLGHVWKDWWKLVYHKLFOHQHHGQRWFRPSOHWHDVXFFHVVIXOVDOYDJHLQVSHF-
WLRQDVSUHVFULEHGXQGHU6HFWLRQRIWKH,OOLQRLV&RPSLOHG6WDWXWHV5HEXLOGHUIXUWKHUDIÀUPVWKDW
WKHYHKLFOHZDVSHUVRQDOO\LQVSHFWHGDQGLWFRPSOLHVZLWKDOOVDIHW\UHTXLUHPHQWVVHWIRUWKLQWKH,OOLQRLV
&RPSLOHG6WDWXWHV&KDSWHUDQGDQ\UHJXODWLRQVSURPXOJDWHGWKHUHXQGHUE\WKH6HFUHWDU\RI6WDWH
,DIÀUPXQGHUSHQDOW\RISHUMXU\WKDWDOOLQIRUPDWLRQFRQWDLQHGLQWKLVDIÀUPDWLRQDQGLWVDWWDFKPHQWVLVWUXHDQG
FRUUHFWWRWKHEHVWRIP\NQRZOHGJH
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
3ULQWHGE\DXWKRULW\RIWKH6WDWHRI,OOLQRLV6HSWHPEHU³³57
5
HEXLOGHU·V1DPH 5HEXLOGHU·V <U
&
RQWUDFWHG5HEXLOGHU·V1DPH 5HEXLOGHU·V <U
7KHXQGHUVLJQHGKHUHE\DIÀUPVWREHWKHRZQHUVRIWKHEHORZGHVFULEHGYHKLFOHDFTXLUHGE\6DOYDJH&HUWLÀFDWH
1
RBBBBBBBBBBBBBBBBBBBBBBBBBBBB$FTXLUHGIURPBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
<UBBBBBBBBBBBBBB0DNHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB9,1BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
(Signature of Rebuilder or Authorized Agent)
Date
(Signature of Contracted Licensed Rebuilder)
Date
Printed by authority of the State of Illinois. October 2017 — 1 — RT 11.16
Print
Reset
CODE FOR ESSENTIAL PARTS LIST
A. Right front fender/rear fender
B. Left front fender/rear fender
*C. Right rear quarter panel/bed side
*D. Left rear quarter panel/bed side
E. Hood
F. Right front door
G. Right rear door
H. Left front door
I. Left rear door
J. Hatchback/deck lid/tailgate/trunk lid
K. Front bumper
L. Rear bumper
M. Front end assembly – (headlights-fenders-hood)
N. Front clip (FEA-with cowl attached)
O. Rear clip (quarter panels-fenders-floor-top)
P. Clip cab (roof-back panel-floor)
Q. Cab (clip cab-with cowl)
R. Bed
S. Frame
T. Engine
U. Transmission
V. Cowl
W. Transmission
X. Chassis/shell/hulk
SEATS RADIOS
AA. Front seat AG. Stereo radio (AM/FM)
AB. Rear seat
AC. Left front seat
AD. Right front seat
AE. Left rear seat
AF. Right rear seat
MOTORCYCLES
AH. Faring
AI. Fuel tanks
AJ. Fork
*Not considered essential parts, may be inspected as part of the Salvage Vehicle Inspection Program.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 7: AFFIRMATION SUPPORTING SALVAGE CERTIFICATE 2IFHRIWKH6HFUHWDURI6WDWH KLVIRUPPXVWDFFRPSDQDOO6DOYDJH&HUWLFDWHVIRUZKLFKD&HUWLFDWHRI7LWOHLVUHTXHVWHG (Illinois Secretary of State)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 9 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document