Florida HSMV 84491 Statement of Builder Form Guide – If you are rebuilding a vehicle, assembling a kit car, or constructing a custom motor vehicle, motorcycle, or mobile home in Florida, accurate documentation is essential for obtaining a proper title. The Florida Department of Highway Safety and Motor Vehicles (FLHSMV) requires Form HSMV 84490, the Statement of Builder, for these applications. When the space on that form is insufficient, you must use the companion document: Florida HSMV Form 84491 – Statement of Builder (Additional Sheet).
This official form, revised in July 2024, provides extra room to list major component parts and describe repairs in detail. It is a critical part of the Florida title application process for rebuilt, assembled-from-parts (ASPT), kit car, and similar vehicles.
Download the official Form HSMV 84491 here: Florida HSMV Form 84491 PDF (Official)
What Is Florida HSMV Form 84491?
Form HSMV 84491 is an official supplemental sheet issued by the Florida Department of Highway Safety and Motor Vehicles. It is designed specifically for use with Form HSMV 84490 (Statement of Builder). The primary form has limited space for listing major component parts used in the building or repair process and for describing repairs. When that space runs out, applicants must continue the information on Form 84491.
The form applies to:
- Rebuilt vehicles (previously declared salvage or junk and restored)
- Assembled-from-parts (ASPT) vehicles
- Kit cars
- Other custom-built or reconstructed motor vehicles, motorcycles, and mobile homes
According to FLHSMV procedures, both forms help the department verify the identity of the vehicle and the legitimacy of all major component parts that were repaired or replaced. This supports Florida’s requirements under Chapter 319 of the Florida Statutes for proper branding of titles as “rebuilt,” “assembled from parts,” “kit car,” or similar designations.
When Do You Need Form HSMV 84491?
You need Form 84491 whenever the information required on Form HSMV 84490 exceeds the available space. Common situations include:
- Listing more major component parts than the primary form allows
- Providing a detailed written description of repairs that cannot fit in the limited lines on Form 84490
- Documenting complex rebuilds involving numerous new, used, repaired, aftermarket, or homemade parts
Form 84490 itself explicitly directs users to Form 84491 when additional space is needed for the parts list or repair description. Both forms must be submitted together as part of a complete title application package for rebuilt or assembled vehicles.
These forms are typically required when applying for a Florida certificate of title after a vehicle has been rebuilt from salvage, assembled from parts, or built from a kit. Applications are generally processed at FLHSMV regional offices or authorized Private Rebuilt Vehicle Inspection Program (PRVIP) facilities.
Key Sections of Florida HSMV Form 84491
The current version of Form HSMV 84491 (Revised 07/24) contains the following main sections:
Header Checkboxes
Applicants select the applicable category:
- REBUILT
- ASPT (Assembled from Parts)
- KIT CAR
- OTHER (with space to specify)
Section I – Description of the Vehicle
This section identifies the vehicle type (Motor Vehicle, Motorcycle, or Mobile Home) and records basic details:
- Year
- Make
- Identification Number (VIN or equivalent)
- Color
- Body
- Length
Section II – Major Component Parts Used in the Building/Repair Process
This is the core of the form. It provides multiple rows to continue listing parts beyond what fits on Form 84490. For each part, applicants indicate:
- Part name/description
- Whether it is New, Used, Repaired, Aftermarket, or Homemade
- Source/VIN (origin of the part and any identifying number)
The form also includes space to continue describing any repairs made in detail.
Section III – Certification and Signature
Applicants must date the form and sign under penalties of perjury, declaring that the facts stated are true and that no material information regarding the motor vehicle, motorcycle, or mobile home has been omitted. Printed names and signatures of the applicant(s) or business are required.
Understanding Major Component Parts in Florida
Florida law (Section 319.30, Florida Statutes) and FLHSMV forms define major component parts carefully. Accurate listing is required because the department inspects these parts to confirm the vehicle’s identity and that parts were obtained legitimately.
For motor vehicles other than motorcycles, major component parts generally include:
- Fender, hood, bumper
- Cowl assembly
- Rear quarter panel, trunk lid, door, deck lid, floor pan
- Engine, frame, transmission
- Catalytic converter
- Airbag
For electric, hybrid, or plug-in vehicles and trucks, additional major component parts include electric traction motors, electronic transmissions, charge ports, DC power converters, onboard chargers, power electronics controllers, thermal systems, and traction battery packs.
Motorcycle and mobile home definitions differ and are specified in the related statutes and procedures. Receipts or bills of sale for all major component parts (showing seller name, address, and signature where required) must accompany the application.
How to Complete and Submit Form HSMV 84491?
Follow these best practices when filling out the form:
- Download the latest official version directly from the FLHSMV website to ensure you have the current revision.
- Complete Form HSMV 84490 first. Use Form 84491 only for overflow information.
- Be precise and consistent. Part descriptions and sources on Form 84491 should clearly continue from the primary form.
- Attach all supporting documentation, including original bills of sale or receipts for major component parts.
- Sign and date under penalties of perjury. Incomplete or inaccurate information can delay or result in denial of the title application.
- Submit the completed forms as part of the full title application package to the appropriate FLHSMV regional office or authorized inspection facility.
Always verify current requirements with the official FLHSMV resources or your local tax collector/license plate agency, as procedures can be updated.
Official download link: Download Florida HSMV Form 84491 – Statement of Builder (Additional Sheet)
You can also find the primary form and related documents on the FLHSMV forms page: FLHSMV Official Forms.
Related Florida Forms and Resources
Form 84491 is almost always used together with:
- HSMV 84490 – Statement of Builder (primary form)
- HSMV 82040 – Application for Certificate of Title (Motor Vehicle or Mobile Home versions)
- Supporting bills of sale/receipts for major component parts
- Proof of ownership (salvage title or equivalent)
For detailed procedural guidance, refer to FLHSMV title procedures such as those covering rebuilt vehicles and vehicles assembled from parts or kits. These procedures outline inspection requirements, documentation checklists, and branding rules for the finished title.
Tips for a Smooth Florida Rebuilt or Kit Car Title Application
- Keep thorough records of every part purchased, including VINs when available.
- Photograph the vehicle before and during repairs when possible (especially for salvage rebuilds).
- Ensure the vehicle is fully assembled and road-operable (or habitable for mobile homes) before inspection.
- Confirm whether your application requires inspection at a regional office or an authorized PRVIP facility.
- Double-check that all forms are the current versions and fully completed.
Proper use of Form HSMV 84491 helps ensure your application meets Florida’s documentation standards and supports a successful title issuance with the correct brand.
Conclusion
Florida HSMV Form 84491 – Statement of Builder (Additional Sheet) is an essential companion form for anyone titling a rebuilt, assembled-from-parts, kit car, or similar vehicle in the state. By providing the extra space needed to fully document major component parts and repairs, it helps applicants meet FLHSMV requirements under Florida law.
Always use the official form from the Florida Department of Highway Safety and Motor Vehicles and pair it with a properly completed Form HSMV 84490. Accurate, complete documentation protects both the applicant and the integrity of Florida’s vehicle title system.