"THIS DISCLOSURE STATEMENT MUST BE GIVEN BY THE SELLER TO THE BUYER EVERY TIME THIS VEHICLE IS KNOWINGLY RESOLD WITH A SALVAGE CERTIFICATE OR TOTAL LOSS HISTORY
DISCLOSURE STATEMENT
Vehicle Identification Number (VIN)
Year: Make: Model:
SALVAGE OR TOTAL LOSS VEHICLE--NOT FOR RESALE WITHOUT DISCLOSURE
WARNING: THIS VEHICLE HAS A SALVAGE OR TOTAL LOSS HISTORY WHICH MAY MATERIALLY AFFECT THE VALUE, SAFETY AND/OR CONDITION OF THE VEHICLE. BECAUSE OF ITS CONDITION THE MANUFACTURER'S WARRANTY OR SERVICE CONTRACT ON THIS VEHICLE MAY BE AFFECTED. THIS VEHICLE MAY NOT BE SAFE FOR OPERATION UNLESS PROPERLY REPAIRED. SOME STATES MAY REQUIRE AN INSPECTION BEFORE THIS VEHICLE IS REGISTERED. THE STATE OF UTAH MAY REQUIRE THIS VEHICLE TO BE PERMANENTLY BRANDED AS A REBUILT SALVAGE VEHICLE. OTHER STATES MAY ALSO PERMANENTLY BRAND THE CERTIFICATE OF TITLE. YOU MAY ASK THE SELLER OF THE VEHICLE TO SEE A COPY OF THE NATIONAL MOTOR VEHICLE TITLE INFORMATION SYSTEM (NMVTIS) VEHICLE HISTORY REPORT. YOU MAY ALSO INDEPENDENTLY OBTAIN THE REPORT BY CHECKING NMVTIS ONLINE AT WWW.VEHICLEHISTORY.GOV.
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Signature of Purchaser Date"
Utah Code § 41-1a-1005.3