Motor Vehicle Commission Special Title Unit P.O. Box 017 Trenton, New Jersey 08666-0017 Application for Salv SALVAGE INSPECTION APPLICATION Out-of-State: (609) 292-6500 ext. 5063 Toll free in NJ: (888) 486-3339 ext. 5063 DATE. PLEASE PRINT Proper delivery depends on a complete address. RE: VEHICLE I.D. NO. YEAR/MAKE/MODEL SALVAGE TITLE CONTROL NO. BUSINESS PHONE: PHONE: ________________________ (HOME) ________________________ (CELL) E-MAIL: NOTICE OF APPOINTMENT FOR VEHICLE IDENTIFICATION INSPECTION Your vehicle must be physically inspected to determine if it conforms to the vehicle description and identification as noted on the salvage title presently held by you in your name before a valid negotiable title can be issued by the Motor Vehicle Commission. NOTE: To comply with the Motor Vehicle Commission and Traffic regulations (Title 39) of the State of New Jersey, YOU MUST tow your vehicle to the inspection site or obtain a 5 day temporary registration at your local Motor Vehicle Agency. If you are a dealer, dealer plates may be used. Date: Time: CHECK INSPECTION SITE BLOCK: Phone Numbers Fax Numbers $200.00 Fee paid (clerk's initials) Asbury Park, 1010 Comstock St. 732-869-8333 732-869-8332 $100.00 (Motorcycle only) Westfield, 410 South Ave 609-468-9664 Winslow, 250 Spring Garden Rd. 609-567-0190 609-567-0652 (NON-REFUNDABLE AND EXPIRES IN ONE YEAR) NO CASH. Check or Money Order Only IMPORTANT 1. The inspection will take approximately one hour. You may NOT observe the inspection of your vehicle. 2. Do NOT bring children with you. 3. Failure to appear for your scheduled appointment will result in forfeiture of your inspection fee unless you request a rescheduling at least 5 .. .. working days prior to the above date. If you are late for the scheduled appointment, you also forfeit the inspection fee and must reapply. COMPLETE THE INFORMATION BELOW AND BRING TO INSPECTION SITE: PREVIOUS OWNER'S NAME STREET ADDRESS CITY STATE, ZIP CODE VEHICLE CONDITION - Check all boxes that apply VEHICLE IDENTIFICATION PLATE MISSING, ALTERED, OR DEFACED FRAME-MUST SURRENDER TlTLE IF AVAILABLE MAJOR COMPONENT PARTS REPLACED ENGINE TRANSMISSION ROOF DECKLID, TAILGATE OR HATCHBACK COWL HOOD OR FRONT END ASSY. DOOR(S) FRONT OR REAR FENDER(S) OR PANEL(S) SHOCK TOWER OR APRON FRONT OR REAR BUMPER(S) OTHER (SPECIFY) ASSEMBLED ITEMS: NOSE (FENDERS, HOOD BUMPER. RADIATOR) SHORT CLIP ( R E A R C L I P WITHOUT ROOF) FRONT CLIP (COWL, FRAME SECTION, SHOCK & APRON STRUCTURE) REAR CUP (REAR SHEET METAL, FRAME SECTION, ROOF) Receipts for parts replaced must accompany the salvage title at inspection. The indentification number of the vehicle they were removed from must be on the receipt. Also required before & after color pictures and work order. CONSENT FOR INSPECTION OF VEHICLE IDENTIFICATION NUMBER I certify the information on this application is true and consent to have the identification of my motor vehicle verified by employees or authorized representatives of the State of New Jersey. This verification may include the removal of parts. Signature of Owner OS/SS-3 (R 11/11) Date For the regulations pertaining to Salvage Certificate of Title (N.J.A.C. 13:21-22), please visit our website at www.njmvc.gov/biz American LegalNet, Inc. www.FormsWorkFlow.com New Jersey Motor Vehicle Commission P.O. Box 017 Trenton, NJ 08666-0017 STATE OF NEW JERSEY Salvage Photos The Motor Vehicle Commission requires before and after photos of the vehicle. These photos must clearly show all four sides of the vehicle. The requirements and restrictions of the ph otos are as follows: The vehicle must be clean and free of any debris or snow. Color photos are required. Photos must be clear. Photos cannot cut off any portion of the vehicle. Photos must be standard size or larger (2¼ X 4¼). Polaroid photos are acceptable. Photo quality paper is required if pictures are self printed. Note:  If  you  do  not  have  before  photos  you  must  first  contact  the  previous  owner.  If  you  are  unsuccessful  in  obtaining  acceptable  before  photos,  a  damage  report  from  the  insurance  company  is  required. This will only substitute for the before photos.  A B C E F D G A, B, & C are all acceptable photos. D is an unacceptable photo and will be rejected because the rear bumper is cut off. E & F are acceptable photos. This is an exampl e of taking a picture that captures two sides of the vehicle in a single picture. G is an unacceptable photo because it cuts off the front, driver side of the vehicle. If you have any questions, feel free to contact any one of the following specialty sites:      Asbury Park: (732) 869‐8333                Westfield: (609) 468-9664        Winslow: (609) 567-0190           American LegalNet, Inc. www.FormsWorkFlow.com