STATE OF DELAWARE
MOTOR VEHICLE DIVISION
P.O. BOX 698
ATTN. REGISTRATION SECTION
DOVER, DELAWARE 19903
DEALER'S NOTIFICATION OF USED VEHICLE RECEIVED

This form is a notification from the Dealer to the Motor Vehicle Division to be sent within twenty-four(24) hours after receipt of every
Delaware registered vehicles. (See Title 21, Section 2510)(f)).

This is notification to the Motor Vehicle Division that

Received a vehicle from ,

Address ,  ,

The vehicle was Not Leased Leased From

Received by Dealer on this Day of , the following described vehicle