Free TR-13a Application for Salvage Vehicle Inspection - Michigan

MICHIGAN DEPARTMENT OF STATE

Clear Form

APPLICATION FOR SALVAGE VEHICLE INSPECTION
(This form must be legibly printed or typed.)
When the vehicle is repaired, present this completed form, the salvage title, and the receipts for all major component parts used in the rebuilding process to a salvage inspector. Names of inspectors in your area may be obtained by visiting a Secretary of State branch office; on the Secretary of State Web site (www.Michigan.gov/sos); or by calling 1-888-SOS-MICH (1-888-767-6424). The salvage inspector will notify the applicant when preliminary background checks have been done and schedule an inspection appointment. The fee for a salvage vehicle inspection is up to $100.00. A completed TR-13A (Application For Salvage Vehicle Inspection) and TR-13B (Salvage Recertification) must accompany a title application for an original rebuilt salvage vehicle title.

Part 1: To Be Completed by Applicant For Inspection:
OWNER'S NAME CURRENT TITLE NUMBER OWNER'S ADDRESS - STREET CITY STATE ZIP + 4

VEHICLE IDENTIFICATION NUMBER

YEAR

MAKE

MODEL

BODY STYLE

COLOR (Top/Bottom)

DEALER NUMBER (If Applicable)

HAS THIS VEHICLE FAILED A PREVIOUS SALVAGE VEHICLE INSPECTION? (If YES, when)

YES
OWNER/APPLICANT'S PRINTED NAME

NO
TELEPHONE NUMBER DATE

I CONFIRM THE ABOVE INFORMATION IS TRUE
OWNER/APPLICANT'S SIGNATURE

(

)

Part 2: Reverse Side of this form.
All major component parts used in the rebuilding of this vehicle must be listed on the reverse side of this form. (All major component parts used must be listed, and all non-salvageable parts listed on the salvage title must be accounted for.)

Part 3: To Be Completed by The Person Responsible For The Repairs:
EXPLAIN WHAT WAS DONE TO REPAIR THIS VEHICLE. IF A MAJOR COMPONENT PART WAS REPAIRED AND NOT REPLACED, EXPLAIN:

Any alteration, forgery, or false statement is a felony and may result in civil liability, fines, or criminal prosecution.
PRINTED NAME OR PERSON RESPONSIBLE FOR REPAIRS DATE REPAIRS COMPLETED

Repairs By Licensed Facilities - Attach Repair Invoices. Repairs By Owner Or Unlicensed Facilities - Attach All Receipts For Major Component Parts.
TR-13A (03/07) By authority of PA 300 of 1949, as amended.

Part 2 Continued:
The major component parts listed here have been used in rebuilding this vehicle. (All Major Component parts used must be listed and all non-salvageable parts listed on the salvage title must be accounted for.)

MAJOR COMPONENT PARTS
Engine Passenger Vehicle Body Pickup Cargo Box Frame Truck Cab
MAJOR COMPONENT PART

Doors Transmission Right or Left Front Fender Hood

Trunk Floor Pan Front or Rear Bumper Right or Left Rear Quarter Panel Deck Lid, Tailgate, or Hatchback
PART SOURCE & ADDRESS

YEAR

MAKE

VIN OR I.D. NUMBER

DATE ACQUIRED

Additional Application for Salvage Vehicle Inspection (TR-13A) forms may be obtained by visiting a Secretary of State branch office; on the Secretary of State Web site (www.Michigan.gov/sos); or by calling 1-888-SOS-MICH (1-888-767-6424).