INDIVIDUAL REBUILT INSPECTION CHECKLIST
NOTE: YOU MUST HAVE ALL REQUIRED DOCUMENTS TO HAVE VEHICLE INSPECTED AND/OR OBTAIN AN INSPECTION APPOINTMENT
☐ Statement of Builder pages 1 & 2 HSMV 84490 Form;
☐ Statement of Builder (Additional Sheet) pages 1 & 2 HSMV 84491 Form (If Needed);
☐ Application for Certificate of Title pages 1 & 2 HSMV 82040 Form;
☐ Original Certificate of Title;
☐ Bill of Sale (Not required if Certificate of Title was transferred to applicant’s name);
☐ Original Parts Receipts (If used parts were used, receipt must list used parts VIN);
☐ Original Repair Order/Receipt (Must be in applicant’s name, list used parts VIN if used parts were used and must be marked “Paid In Full”);
☐ Photos (4×7 or larger) of ALL 4 sides of the vehicle and the inside of the vehicle BEFORE repairs (see attached example) or Insurance Damage Report;
☐ Power of Attorney HSMV 82053 Form if someone other than the owner is present;
☐ Copy of owner’s Driver License.
NOTE: All required documents that are provided MUST BE ORIGINAL DOCUMENTS, which are required prior to conducting your vehicle inspection. If you do not provide original documents, you will be rescheduled for your inspection.