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Get IA Form 411008 2003-2024

T page ( Last Name First Name Middle Initial ) ( ) Home Phone # Work Phone # , Iowa Mailing/Residence Address County City Zip Code Name & Address of person from whom the vehicle was acquired (please print) Vehicle Identification Number Model Number Vehicle Make Year Vehicle Type (car, truck, trailer): I have knowledge the motor vehicle was previously junked or titled as salvaged, rebuilt, or flood in this or any other state. Yes No I/We certify under penalty of perjury that t.

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