Personal Property Disposal Form

2. 
   COMMISSIONER OF THE REVENUE

   COUNTY OF HENRY

   PO BOX 1077

   COLLINSVILLE VA 24078-1077

   PHONE: (276) 634-4690

3. PERSONAL PROPERTY DISPOSAL FORM
5. Please submit this form if you have gotten rid of your personal property such as vehicle, boat, trailer, etc.

   NOTE: Turning your tags in to the DMV does not mean the vehicle has been titled out of your name. You must contact the DMV. You can contact the DMV at www.dmvnow.com or 804.497.7100. 

7. Customer Number*
9. First Name*
10. Middle Initial
11. Last Name*
13. Phone Number*
14. Email Address
16. Street Number and Name*
18. Apt/Unit Number
20. City*
21. State*
22. Zip Code*

24. Please report the personal property that has been disposed via trade-in, sold, totaled, etc.

26. Property Type*
    -- Select One --Car/TruckMotorcycleBoatMobile HomeMotor HomeTrailer
27. Vehicle Identification Number (VIN)*
29. Title Number
30. Model Year*
31. Model Make*
33. Date of disposal*
    Date of disposal
34. Type of disposal*
    -- Select One --SoldTrade-InTotaledJunked/ScrappedDonatedOther
36. Did you report the disposal to the VA DMV within 30 days?*

    1. Yes
    2. No - Important: Please contact the DMV so the vehicle can be titled out of your name. This is the best way to ensure you do not receive a tax bill for this personal property. Contact information for the DMV is at the top of this form.
38. Electronic Signature Agreement*

    The submission of this form does not automatically relieve tax liability. All submissions are subject to review and audit by the Commissioner of the Revenue's Office. Please pay all current taxes due by the associated due date unless otherwise notified by our office.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, 3) you may still be required to provide a traditional signature at a later date, and 4) you certify that the information given by you in this form is true, correct, and accurate to the best of my knowledge and belief.

    1. I agree.
40. Electronic Signature*
41. Date*
    Date
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field