STK# 300450735-6927 (1-18)
STOLEN VEHICLE NOTIFICATION
(Instructions on back)
PLATE NUMBER YEAR MAKE BODY STYLE
VEHICLE IDENTIFICATION NUMBER
NAME(S) OF REGISTERED OWNER(S)
STREET ADDRESS, CITY, STATE AND ZIP CODE
TITLE NUMBER
X
SIGNATURE
DATE RECOVERED: ______________________
Section 1 - Unrecovered Stolen Vehicle - Complete this form* if it has been at least 30 days
since your vehicle was stolen, the vehicle has not been recovered, and the loss is not covered by
insurance. Detach and mail Section 1 to the address on the back of this form, along with evidence
that the vehicle was reported stolen to law enforcement. If this information is not included, the
notice will not be filed.
PLATE NUMBER
YEAR MAKE BODY STYLE
VEHICLE IDENTIFICATION NUMBER
POLICE AGENCY REPORTED TO
NAME(S) OF REGISTERED OWNER(S)
STREET ADDRESS, CITY, STATE AND ZIP CODE
TITLE NUMBER
POLICE REPORT NUMBER
DATE OF THEFT DATE REPORTED
SIGNATURE
X
Yes – Do NOT complete Section 2.
See the instructions on the back of this form for more information.
No – The vehicle is not considered “totaled.” However, a vehicle identification number
inspection is required before the vehicle can be retitled. See the back of this form for
instructions.
Is the vehicle damaged and is the estimated cost to repair the vehicle at least 80% of its
retail market value before the damage?
Section 2 – Recovered Stolen Vehicle - Complete this form if you previously notified DMV that
your vehicle was stolen by sending in Section 1 and the vehicle has now been recovered.
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A
C
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A
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Loss NOT Covered By Insurance
* Completion of this form does not place a notation on DMV's records to indicate the vehicle has been stolen; it only
satisfies the notification requirement of ORS 819.012 (1) (b), indicating the vehicle meets the definition of a totaled
vehicle. Contact your local law enforcement agency to report the vehicle stolen.
Clear Form
If you have questions, call DMV’s Totaled Vehicle Desk at (503) 945-5122
STOLEN VEHICLE INSTRUCTIONS
If the vehicle is recovered:
You must first determine if the vehicle is damaged. Is the estimated cost to repair the vehicle at least
80% of its retail market value before the damage?
If your answer to the question is “ Yes,” you must surrender the title or primary ownership document to
DMV, unless you have transferred it to the recovering tower within 30 days of the recovery date, and do one
of the following:
a. apply for a salvage title; or
b. if the vehicle is repaired, rebuilt, or eligible for a certificate of title, apply for title showing the
vehicle as “totaled” and assembled, reconstructed, or replica; or
c. surrender the title or primary ownership document to DMV, along with a statement indicating that
the vehicle is totaled and that you do not intend to rebuild or repair the vehicle, to transfer
ownership of the vehicle frame or unibody, or to use the frame or unibody for repairing or
constructing another vehicle.
If your answer to the question is “ No,” complete Section 2 of the form and follow these instructions.
a. If the vehicle is not considered “totaled,” and you wish to remove the totaled notation from the
vehicle record now, you must go to a full service DMV office to have a vehicle identification
number (VIN) inspection done. There is a fee for the inspection. Submit Section 2 of this form,
with the VIN inspection, to remove the totaled notation.
b. If you do not wish to have a VIN inspection performed now, complete Section 2 of the form and
send it to: DMV–Totaled Vehicle Desk, 1905 Lana Ave NE, Salem Oregon 97314. The totaled
notation will be removed, but a new notation will be added indicating that a VIN inspection is
required before the vehicle can be retitled.
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RECOVERED VEHICLE INSTRUCTIONS
• If the loss is covered by insurance:
1. Report the theft to law enforcement, and
2. Report the theft to your insurance company.
Because the insurance company is required to report the theft to DMV, you do not
need to complete this form.
DMV - Totaled Vehicle Desk
1905 Lana Ave NE
Salem OR 97314
Who must notify DMV:
• A registered owner, as maintained in DMV’s record of the vehicle.
• If you own the vehicle, but haven't transferred the title, apply for title in your name. Submit completed
Section 1 of this form, along with the title application.
How to notify DMV:
• Complete only Section 1 on the front of this form.
• You must include evidence that the vehicle was reported as stolen to law enforcement, otherwise
the notice will not be filed. Evidence may include:
• A copy of the police report;
• A police report number and the name of the agency the theft was reported to; or
• Other verification of the report.
• Detach Section 1. Retain Section 2 for use if the vehicle is recovered.
• Mail Section 1 to:
• If the loss is not covered by insurance:
1. Report the theft to law enforcement, and
2. Wait at least 30 days. If the vehicle has not been recovered after 30 days,
you then must notify DMV within 60 days of the date of the theft. Failure to notify DMV
is a Class A Misdemeanor and is punishable by a jail sentence of up to one year, a fine
of up to $6,250, or both.
What to do when your vehicle is stolen:
