Out
of State "VIN" (Vehicle Identification Number)
Inspection Application to County Clerk for Motor Vehicle
Certificate of Title
Wyoming Department of Transportation
P.O. Box 1708
Cheyenne, Wy 82003-1708
307-777-4709
Applicant Information
Owner's Name
______________________________________________
Owner's
Address
______________________________________________
Seller's
Name
______________________________________________
Seller's
Address
______________________________________________
Vehicle Information
Make
_______________
Year
________________
Model
_______________
Odometer
____________
New
Used
Purchase
Date ______________
Affidavit of Inspection and Certification of
"VIN"
I
have physically inspected the above described vehicle
to verify the Identification Number.
The Vehicle Identification Number is:___________________________________________
The
inspection occurred in ____________________
___________ (City)
(State)
The
ispection was made by:
City Police Dept
County Sheriff's Office
Highway Patrol
Commissioned Military Officer
At
the request of the applicant, I personally inspected the
vehicle Identification Number on the described vehicle
and the information entered by me is correct. (Please
print)
Officer's
Name _________________________ Badge Number ________________
Agency
and Location _________________________________________________
Telephone Number __________________________ Date
___________________
Signature __________________________________
Notary Statement
Subscribed
and sworn to before me this _______ day of ________, 20
______
_______________________________
Signature of Notary
