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Ct Abandoned Vehicle Form 2016-2023
$1500
WAS NOTICE OF INTENT TO SELL SENT TO OWNER?
NO
YES
ADDRESS
NAME OF DEALER/REPAIRER
SELLER
INFORMATION
ADDRESS OF DEALER/REPAIRER
DEALER/REPAIRER LICENSE NUMBER
DATE VEHICLE PLACED IN CUSTODY OF DEALER/REPAIRER
TOWING CHARGES (If any)
STORAGE CHARGES (If any)
LIEN
INFORMATION
REPAIR CHARGES (If any)
$
$
OTHER CHARGES (If any, specify)
TOTAL OF ALL CHARGES
$
$
NAME (Owner)
ADDRESS
PURCHASER(S)
DATE OF SALE
PLACE OF SALE
SALES PRICE
$
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