Notwithstanding any other provision of this chapter to the contrary, if the owner or authorized agent of the owner has not obtained a title in his or her name for the vehicle to be transferred, has lost the title for the vehicle to be transferred, or has returned the title to the Department of Revenue in accordance with Section 63-21-39(1)(a), he or she may sign a statement swearing that, in addition to the foregoing conditions, the vehicle is at least ten (10) model years old. The statement described in this paragraph may be used only to transfer such a vehicle to a licensed used motor vehicle parts dealer or scrap metal processor. The department shall promulgate a form for the statement which shall include, but not be limited to: 1. Never obtained a title to the vehicle in his or her name; or
2. Was issued a title for the vehicle, but the title was lost or stolen;
1. Is at least ten (10) model years old; and
2. Is not subject to any security interest or lien;
1. It is a misdemeanor, punishable by a fine of not more than One Thousand Dollars ($1,000.00) or imprisonment for not more than six (6) months, or both, for conviction of a first offense of knowingly falsifying any information on this statement; and
2. It is a felony, punishable by a fine of not less than One Thousand Dollars ($1,000.00) nor more than Five Thousand Dollars ($5,000.00) or imprisonment for not less than one (1) year nor more than five (5) years, or both, for conviction of a second or subsequent offense of knowingly falsifying any information on this statement;
- A statement that the vehicle shall never be titled again; it must be dismantled or scrapped;
- A description of the vehicle including the year, make, model and vehicle identification number;
- The name, address, and driver's license number of the owner;
- A certification that the owner:
- A certification that the vehicle:
- An acknowledgment that the owner and buyer of the vehicle realizes this form will be filed with the department and that:
- The owner's signature and the date of the transaction;
- The name and address of the business acquiring the vehicle;
- The National Motor Vehicle Title Information System identification number; and
- The business agent's signature and date along with a printed name and title if the agent is signing on behalf of a corporation.