MV-010 www.hctax.net Rev 07/14 v.1
Franchise Dealer Inventory Affidavit
The following statement is being submitted for inventory item(s) _____________________________________.
(List the specific inventory number)
To the best of my knowledge the item listed should be voided because:
The item was lost and could not be found in order to return to the Tax Office.
Our customer has possession of the inventory and will not return it.
Our dealership did not receive the Form 31(s) listed.
Our dealership did not receive the License Plate(s) listed.
The inventory was issued and processed. I have included a Dealer Complete report.
Other :
**. Only one statement is needed for consecutive items.**
Representative’s Signature
Date
Representative’s Printed Name
D/
Dealership Name and D#