Free 39530.FH8 - Indiana

AFFIDAVIT OF POLICE OFFICER Physical Inspection of an Indiana Resident's WATERCRAFT
State Form 39530 (R4 / 12-96)

INSTRUCTIONS:

Use reverse side for vehicle.

Indiana Code does not permit watercraft inspections by watercraft dealers. NOTE: There are no provisions in the Indiana Code for assessing an inspection fee.
NOTE TO LAW OFFICER

1. A Title or Certificate of Origin does not have to be present to complete this affidavit. 2. You are required to physically inspect the watercraft to verify the existence and condition of the Hull Identification Number.

Name of owner

Address of owner

WATERCRAFT INFORMATION

I, the undersigned law enforcement officer, hereby swear or affirm that I have personally examined the watercraft described as follows:
Year Make Model Length ft. Indiana Registration Number Hull Identification Number (HIN)

NOTE TO LAW OFFICER THE BMV WILL NOT ACCEPT THIS AFFIDAVIT IF THE INFORMATION REQUESTED IN THIS BOX IS NOT COMPLETE AND LEGIBLE. Printed name of inspecting officer Title of inspecting officer

Name of department

City

State

ID number

T elephone number

(

)

I swear or affirm that the information I have entered on this form is correct. I understand that making a false statement on this form may constitute the crime of perjury.
Signature of inspecting officer Date signed (month, day, year)

AFFIDAVIT OF POLICE OFFICER Physical Inspection of an Indiana Resident's VEHICLE
State Form 39530 (R4 / 12-96)

INSTRUCTIONS:

Use reverse side for watercraft.

In accordance with Indiana Code 9-29-4-2, a fee not to exceed $5.00 may be assessed. However, a law enforcement agency cannot collect any fee until they meet all provisions found under IC 9-29-2. Authorized Indiana dealers cannot assess a fee.
NOTE TO LAW OFFICER / AUTHORIZED INDIANA DEALER

1. A Title or Certificate of Origin does not have to be present to complete this affidavit. 2. You are required to physically inspect the vehicle to verify the existence and condition of the vehicle ID number.
Name of owner Address of owner

I, the undersigned law enforcement officer / authorized Indiana dealer, hereby swear or affirm that I have personally examined the vehicle described as follows:
Year 1. VEHICLE INFORMATION (if vehicle was assembled, go to Item 2) Make Type (i.e. motorcycle, RV, van)

Plate number / State

Vehicle Identification Number (VIN)

Year

2. VEHICLE INFORMATION FOR AN ASSEMBLED UNIT (assembled means any unit that does not have a manufacturers VIN in place) Make Type (i.e. motorcycle, RV, van)

ASM
Plate number / State Vehicle Identification Number (VIN)

If present, please provide serial numbers for major component parts.
Engine Frame Transmission Other (specify)

3. WAS AN IDACS / NCIC CHECK PERFORMED? (Police Officer only) Check one If Yes, did VIN conform to standards?

Yes

No

Yes

No

NOTE TO LAW OFFICER / AUTHORIZED INDIANA DEALER THE BMV WILL NOT ACCEPT THIS AFFIDAVIT IF THE INFORMATION REQUESTED IN THIS BOX IS NOT COMPLETE AND LEGIBLE. Printed name of inspecting officer Title of inspecting officer

Name of department / dealership

City

State

ID number / Dealer number

T elephone number

(

)

I swear or affirm that the information I have entered on this form is correct. I understand that making a false statement on this form may constitute the crime of perjury.
Signature of inspecting officer Date signed (month, day, year)