
DR 2424 (01/18/12)
COLORADO DEPARTMENT OF REVENUE
DIVISION OF MOTOR VEHICLES
TITLE SECTION
www.colorado.gov/revenue
STATE OF COLORADO
REBUILT FROM SALVAGE TITLE
STATEMENT OF FACTS
C.R.S. 42-6-136, 42-6-206
Vehicles branded as salvage may have been repaired to make them roadworthy, allowing for application of a Rebuilt from Salvage title.
SALVAGE TITLE NUMBER DATE
This is to certify that the vehicle described herein is now roadworthy to travel the streets and highways of the State of Colorado.
MAKE YEAR MODEL VIN
DATE OF PURCHASE NAME OF SELLER PURCHASE PRICE
List the parts used to make this vehicle roadworthy:
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List the repairs made to make this vehicle roadworthy:
__________________________________________________________________________________________________________
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I completed this work myself , or I authorized the repairs to be completed by _____________________________________________
of _______________________________________________________________________. The invoices/receipts for the parts and labor
I am at this time applying for a Colorado Rebuilt from Salvage Title in the name of ____________________________________________
I certify, under penalty of perjury in the second degree, that the above statements are true and accurate to the best of my knowledge.
Signature of Applicant Date
VERIFICATION OF P.O.S.T. CERTIFIED INSPECTOR
I hereby certify that I personally examined the vehicle listed above, this statement of fact, and the invoices/receipts used in the repair
of this vehicle, and that the vehicle has been stamped with the wording “REBUILT FROM SALVAGE.”
Date of Inspection
Signature of Inspector
Inspector’s Title Agency