Florida HSMV Form 84490 Statement of Builder Guide

Florida HSMV Form 84490 Statement of Builder Guide – If you are rebuilding a salvage vehicle, assembling a vehicle from parts, building a kit car, or applying for a Florida title on a custom or street rod vehicle, you will almost certainly need Florida HSMV Form 84490 – Statement of Builder. This official form from the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) is a critical document in the title application process for rebuilt and assembled vehicles.

This guide explains what the form is, when it is required, how to complete it correctly, what supporting documents you need, and where to download the current official version. All information is based on current FLHSMV resources and procedures.

What Is Florida HSMV Form 84490 – Statement of Builder?

Form HSMV 84490, officially titled Statement of Builder, is the document used to provide a detailed description of a motor vehicle, motorcycle, or mobile home that has been rebuilt, repaired, assembled from parts (ASPT), or constructed as a kit car or custom vehicle.

The form is completed by the applicant (the builder or owner) and reviewed/signed by a Florida Highway Safety and Motor Vehicles Compliance Examiner or a Private Rebuilt Vehicle Inspection Program (PRVIP) inspector. It documents the major component parts used, the condition of the vehicle, and required attestations under Florida law.

The current version is revised 05-2024. Always use the latest official form available from FLHSMV.

Official Download: Download Florida HSMV Form 84490 – Statement of Builder (PDF)

When Is Form HSMV 84490 Required?

You must submit a completed Statement of Builder in these common situations:

  • Applying for a rebuilt title on a previously salvage or total-loss vehicle that has been repaired to road-operable condition.
  • Titling a vehicle assembled from parts (ASPT designation).
  • Titling a kit car.
  • Titling a custom vehicle or street rod (additional attestation required under Section 320.0863, Florida Statutes).
  • Certain mobile home rebuilds or assemblies.
  • Cases involving homemade frames or significant major component replacement.

The form is typically submitted together with the Application for Certificate of Title (HSMV 82040 series) and supporting documentation during the inspection and title process at a regional office or through an authorized channel.

Key Sections of Form HSMV 84490

The form is divided into clear sections. Understanding each part helps ensure accurate completion and avoids rejection.

Section I – Description of the Vehicle

Provide the year, make, identification number (VIN), color, body style/length, existing title number(s) and state(s). You must initial that the motor vehicle or motorcycle is complete and in road-operable condition, or that a mobile home is habitable.

Section II – Major Component Parts Used in the Building/Repair Process

This is one of the most important sections. You must list every major component part used, indicate whether each part is new, used, repaired, aftermarket, or homemade, and provide the source/VIN when available.

Major component parts for motor vehicles (other than motorcycles) generally include: fender, hood, bumper, cowl assembly, rear quarter panel, trunk lid, door, deck lid, floor pan, engine, frame, transmission, catalytic converter, and airbag. Electric, hybrid, and plug-in vehicles have additional listed components such as electric traction motors, battery packs, and related systems.

Motorcycle and mobile home major component parts have their own definitions under FLHSMV procedures.

If more space is needed, use the companion form HSMV 84491 – Statement of Builder (Additional Sheet).

You must also state the total number of receipts and attach the original bills of sale or receipts for all major component parts. Receipts must show the seller’s name, address, telephone number, and signature (business receipts may not require a signature). Engine receipts should include the year of the engine.

Section III – Custom Vehicle or Street Rod

If the vehicle qualifies as a custom vehicle or street rod, you must check the required boxes attesting that the vehicle will not be used for general daily transportation and that it meets the safety and equipment requirements in effect for the model year shown on the title. Failure to complete this section when applicable will result in rejection of the application.

Section IV – Applicant Information and Signature

The applicant (or business) certifies under penalties of perjury that the vehicle conforms to Florida and Federal Motor Vehicle Safety Standards and that all information provided is true and complete. Printed name, address, telephone number, and signature are required.

Section V – HSMV Office Use Only

This section is completed by the Compliance Examiner or PRVIP Inspector. It includes VIN verification, inspection results, odometer information, checks for prior rebuilt status, NICB, theft, flood damage, component part marking, and other official findings. The examiner’s signature attests to the inspection and VIN verification.

Supporting Documents Typically Required with Form 84490

In addition to the completed Statement of Builder, applicants generally need:

  • Completed Application for Certificate of Title (HSMV 82040 MV for motor vehicles, or the appropriate version for mobile homes).
  • Proof of ownership (Florida or out-of-state title, or other acceptable documentation).
  • Original bills of sale or receipts for all major component parts (in the name of the applicant/builder).
  • Photographs of the vehicle (often required before and/or after rebuild).
  • Payment of applicable inspection fees (currently $40 for the initial examination in many cases, with lower fees for subsequent inspections) and title fees.
  • Any additional forms required for the specific situation (e.g., bonded title documents if ownership is incomplete).

Exact requirements can vary slightly depending on whether the vehicle is rebuilt, ASPT, a kit car, or involves a homemade frame. Regional Compliance Examiners review the package for completeness.

How to Download and Submit Form HSMV 84490?

Always obtain the form directly from the official FLHSMV website to ensure you have the current revision:

Official Florida HSMV Form 84490 – Statement of Builder (PDF)

Additional sheet (if needed): HSMV 84491 – Statement of Builder Additional Sheet

You can also locate the form on the main FLHSMV Forms page under the numbered list: FLHSMV Official Forms.

Completed forms and supporting documents are typically presented during the physical inspection at a designated regional office or through an authorized PRVIP inspection facility, then forwarded for title processing through a tax collector’s office or license plate agency.

Tips for Successful Completion and Approval

  • Use the most recent revision of the form (currently 05-2024).
  • List every major component part accurately and match the number of receipts stated on the form to the actual documents submitted.
  • Keep original receipts organized and ensure they contain the required seller information.
  • Do not paint the vehicle before inspection if the procedure requires the examiner to see component markings or repairs.
  • Ensure the vehicle is complete and in road-operable (or habitable) condition before inspection.
  • Work with a knowledgeable Compliance Examiner or reputable rebuilt inspection facility if you are unfamiliar with the process.

Related Official Resources

Conclusion

Florida HSMV Form 84490 – Statement of Builder is an essential document for anyone seeking a rebuilt, ASPT, kit car, custom, or street rod title in the state of Florida. Accurate completion, proper documentation of major component parts, and successful inspection by a Compliance Examiner or PRVIP inspector are key to obtaining your Florida certificate of title.

Download the official form directly from FLHSMV, gather all required receipts and supporting paperwork, and follow current procedures carefully. When in doubt, contact your local tax collector’s office or a Florida regional office of the Department of Highway Safety and Motor Vehicles for the most up-to-date guidance specific to your vehicle.

Leave a Comment