Form Tc-661 - Certificate Of Inspection Form - Utah State Tax Commission
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Utah State Tax Commission
TC-661
Get forms online - tax.utah.gov
Rev. 8/06
Certificate Of Inspection
Division of Motor Vehicles · 210 North 1950 West · Salt Lake City, Utah 84134 · (801) 297-7780 or 1 800 DMV-UTAH (TDD 297-2020)
Units registered in the State of Utah for the first time (except new units sold by licensed and bonded Utah dealers)
must be inspected by a MV Customer Service employee, designated contractor, Utah peace officer, licensed dealer
or a certified safety inspector (mechanic). The signature in section 4 verifies that the officer or agent has physically
inspected the identification number (VIN/HIN) as it appears on the unit.
Inspection by out-of-state peace officers and authorized agents of other state motor vehicle agencies will be accepted.
Any Alteration or Erasure Will Void This Document.
1. Customer Information
Name (print last, first, middle)
Address (street, city, state, zip)
2. Vehicle Information
VIN/Serial number
1
3
5
6
8
9
10
13
15
16
2
4
7
11
12
14
17
VIN location
Plate number
Body-right
Trunk
On engine
Visible through windshield
State of issue
Body-left (driver side)
Engine compartment
Frame
Other: _______________________
Make
Model
Body style
Cylinders
Year
Check the box that applies
Gas
Diesel
Propane
Other _______________________________
3. Boat Information
Hull identification number
1
2
3
4
5
6
7
8
9
10
11
12
Make
Model
Year
Hull material
Length
Glass or fiberglass
Wood
Steel
Feet:
Inches:
Aluminum
Rubber
Plastic
Propulsion type
Single/Twin
Total horse power
Fuel
Inboard (ex. I/O & Jet)
Jetdrive
Outboard
Outboard outdrive
Airboat
Sailboat
4. Certification
Only a MV Examiner, designated contractor, Utah peace officer, licensed dealer or a certified safety inspector (mechanic)
may sign below verifying that the officer or agent has physically inspected the identification number (VIN/HIN) as it
appears on the unit.
Inspection by out-of-state peace officers and authorized agents of other state motor vehicle offices will be accepted.
This is to certify that I have personally inspected the unit described above and find the description to be correct.
Date
Signature of officer or agent
X
Badge, dealer or safety inspection no.
Department, dealer or station name
Address
5. Law Enforcement Only
Signature of officer
Badge number
Date
NCIC check performed
X
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