Seller Name and Contact Information: ______________________________________________________________

Year__________Make_________________________Model_______________________Color____________

VIN_____________________________________________Odometer___________________________________

None

Noted Yes Describe, if yes (attach separate page if needed).

DISCOVERED SAFETY ISSUES ____ ____ ____________________________________

CHASSIS OR STRUCTURAL DAMAGE ____ ____ ___________________________________________

NON INDUSTRY-STANDARD REPAIR ____ ____ ___________________________________________

UNREPAIRED DAMAGE ____ ____ ___________________________________________

CHASSIS INSPECTION None

Noted Yes Location – Details, if yes

Frame/Unibody Repair/Welds ____ ____ ___________________________________________

Frame Machine Pinch Marks ____ ____ ___________________________________________

Other ____ ____ ___________________________________________

BODY PANEL INSPECTION None

Noted Yes Location – Details, if yes

Replaced Body Panels ____ ____ ___________________________________________

Damaged/Repaired Body Panels ____ ____ ___________________________________________

Uneven Body Panel Gaps ____ ____ ___________________________________________

Other ____ ____ ___________________________________________

PAINT INSPECTION None

Noted Yes Location – Details, if yes

Difference in Paint Color/Texture ____ ____ ___________________________________________

Uneven Paint Thickness ____ ____ ___________________________________________

Aftermarket Overspray/Mask-lines ____ ____ ___________________________________________

Other ____ ____ ___________________________________________

Was motor vehicle placed on a lift to inspect chassis?__Yes__No

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Good faith estimate whether discovered prior alteration/damage/repair cost exceeds six percent of sales Price:__Yes__No

Cost of Inspection: $_________________ Date of Inspection:___________________________

Inspector Name:______________________________________

Inspector Contact Information:____________________________________________________________________

Inspector Signature:____________________________________________

PRIOR ALTERATION/DAMAGE/REPAIR INSPECTION IS BASED ON GOOD FAITH OBSERVATION, MINIMAL DISASSEMBLY AND WITHOUT USE OF COMPUTERIZED MEASURING SYSTEM(S). See NMAC 12.2.14.1, et seq., (NOT A WARRANTY.)

HISTORY OF 12.2.14 NMAC: [RESERVED]

[12.2.14.14 NMAC - N, 8/31/2016]