Fillable Verification Vehicle Identification N (Town of Charlestown)

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Verification Vehicle Identification N (Town of Charlestown)

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John J. Barthelmes
Commissioner of Safety
State of New Hampshire
Department of Safety
Division of Motor Vehicles
Bureau of Title and Anti-Theft
Concord, N.H. 03305 (603) 227-4150
Director of Motor Vehicles
VERIFICATION OF VEHICLE IDENTIFICATION
This is to certify that I have physically examined at , N.H., the vehicle described herein:
Location
Year
Make
Model
Body Style
Owner’s Reg. No.
and found the vehicle identification number to be
The vehicle identification number appears to be Altered Changed Missing
Owner of Vehicle Address
I further certify that the above referred to Vehicle Identification Number was not obtained from any registration or documents relative to this
vehicle and was obtained by a visual inspection of the Public V.I.N. Plate.
By Date
Agent’s Signature
This form may only be completed by:
This application is signed under penalty of unsworn falsification
pursuant to RSA 641:3.
New Hampshire Law Enforcement Officer Badge # Agency
Authorized N.H. Licensed Auto Dealer Plate # Address
Authorized N.H. Inspection Station # Tel. No.
TDMV 19A (Rev. 07/11)
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Verification Vehicle Identification N (Town of Charlestown)

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Completed 14 July 2020

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