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Get VA VSA 41 2015

REPRESENTATIVE NAME (print) SIGNATURE DATE(mm/dd/yyyy) DMV USE ONLY DMV recognized the NADA Official Used Car Guide trade in value: $_____________ NADA Trade in Value: (Check applicable box.) $12,501 to $25,000 (Must petition General District Court) CSR STAMP CSR STAMP NCIC Checked: is vehicle reported stolen? YES NO $3,000 or less and $3,001 to $12,500 (DMV may process title application) $25,001 or more (Must petition the Circuit Court) CSR STAMP WORK CENTER CLERK STAMP VSA WORK CENT.

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