Get Form Vsa 62

VSA 62 09/10/2012 REPORT OF LEVIED AND SEIZED VEHICLE Code of Virginia 46. 2-644 Purpose Instructions Authorized officials use this form to report a levied and seized motor vehicle trailer or semitrailer. The official making the vehicle seizure must complete all sections of this form and return it to DMV Titling Work Center at the above address. COURT NAME VEHICLE IDENTIFICATION NUMBER VIN AUTHORIZED OFFICIAL NAME COURT INFORMATION PLAINTIFF NAME DEFENDANT NAME YEAR MAKE MODEL CERTIFICATION BODY TYPE DATE OF VEHICLE SEIZURE mm/dd/yyyy COLOR PLATE NUMBER SHERIFF SERVICES REQUIRED YES NO AGENCY CITY STATE ZIP CODE I certify and affirm that all information presented in this form is true and correct that any documents I have presented to DMV are genuine and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation* DATE mm/dd/yyyy. The official making the vehicle seizure must complete all sections of this form and return it to DMV Titling Work Center at the above address. COURT NAME VEHICLE IDENTIFICATION NUMBER VIN AUTHORIZED OFFICIAL NAME COURT INFORMATION PLAINTIFF NAME DEFENDANT NAME YEAR MAKE MODEL CERTIFICATION BODY TYPE DATE OF VEHICLE SEIZURE mm/dd/yyyy COLOR PLATE NUMBER SHERIFF SERVICES REQUIRED YES NO AGENCY CITY STATE ZIP CODE I certify and affirm that all information presented in this form is true and correct that any documents I have presented to DMV are genuine and that the information included in all supporting documentation is true and accurate. COURT NAME VEHICLE IDENTIFICATION NUMBER VIN AUTHORIZED OFFICIAL NAME COURT INFORMATION PLAINTIFF NAME DEFENDANT NAME YEAR MAKE MODEL CERTIFICATION BODY TYPE DATE OF VEHICLE SEIZURE mm/dd/yyyy COLOR PLATE NUMBER SHERIFF SERVICES REQUIRED YES NO AGENCY CITY STATE ZIP CODE I certify and affirm that all information presented in this form is true and correct that any documents I have presented to DMV are genuine and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation* DATE mm/dd/yyyy. The official making the vehicle seizure must complete all sections of this form and return it to DMV Titling Work Center at the above address. COURT NAME VEHICLE IDENTIFICATION NUMBER VIN AUTHORIZED OFFICIAL NAME COURT INFORMATION PLAINTIFF NAME DEFENDANT NAME YEAR MAKE MODEL CERTIFICATION BODY TYPE DATE OF VEHICLE SEIZURE mm/dd/yyyy COLOR PLATE NUMBER SHERIFF SERVICES REQUIRED YES NO AGENCY CITY STATE ZIP CODE I certify and affirm that all information presented in this form is true and correct that any documents I have presented to DMV are genuine and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation* DATE mm/dd/yyyy.