SHP-498A 05/12 MISSOURI STATE HIGHWAY PATROL JUNK, …

[Pages:1]MISSOURI STATE HIGHWAY PATROL

JUNK, SALVAGE, OR REBUILDING AFFIDAVIT

SHP-498B 04/23

INSTRUCTIONS: This affidavit is not for use in determining title type or brand. This affidavit documents the sale/purchase of a motor vehicle without a valid motor vehicle safety inspection. The buyer shall complete the affidavit in the presence of a notary public; the notarized affidavit shall be retained by the seller.

Year

Make

Model

Vehicle Identification Number

Vehicle Mileage

Name of Seller

I, the buyer of the above-referenced motor vehicle, certify I am purchasing a vehicle for junk, salvage, repair or rebuilding purposes that has not been safety inspected to ensure safe operating condition. I understand this vehicle cannot be registered in Missouri until a Missouri motor vehicle safety inspection is performed (when so required by law) and an approval certificate is issued. Furthermore, I understand this vehicle cannot be operated on a public roadway until properly registered.

I make this purchase understanding that repair of any defective components identified during any Missouri motor vehicle safety inspection is my financial responsibility.

I certify I have read the above statements, or the above statements have been read to me, and that I fully understand the conditions under which this vehicle is being sold/purchased.

Purchaser's Printed Name Purchaser's Mailing Address

Purchaser's Signature

NOTE: Operation of this vehicle, without proper inspection and registration, upon the public roadways of Missouri is a violation of Section 307.380, RSMo., and may subject the operator to penalties pursuant to Sections 307.380 and 307.390, RSMo., 1986. A valid Missouri motor vehicle safety inspection approval certificate must be presented at the time of application for registration

----------------------------------------------FOR NOTARY PUBLIC USE ONLY----------------------------------------

--

Subscribed and sworn to before me this

day of

,

Day

Month

Year

Notary Public

County of

, State of Missouri.

My commission expires

.

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