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MVD - 11103 INT. 01/91 STATE OF NEW MEXICO - MOTOR VEHICLE DIVISION SALVAGE VEHICLE OR VESSEL NOTIFICATION OWNER INFORMATION Name or Registered Owner s Check Here if Self Insured Address City State Zip Code VEHICLE / VESSEL INFORMATION Year Make Model Vehicle or Hull Identification Number Body Type Series License Plate or Boat No. Insurance Claim No. INSURANCE COMPANY INFORMATION IF OWNER NOT SELF-INSURED Company Name Stolen and never recovered a.

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