Form HSMV 84491. Statement of Builder (Additional Sheet) - Florida

Form HSMV 84491 is an additional sheet used in conjunction with Form HSMV 84490, the Statement of Builder. This form provides extra space for builders to provide detailed information about the assembly or reconstruction process when the space provided on Form HSMV 84490 is insufficient.

The form consists of sections and important fields that are similar to Form HSMV 84490, including:

• Builder Information
• Vehicle Information
• Assembly/Reconstruction Details
• Statement and Signature

When filling out this form, it is important to reference the corresponding section on Form HSMV 84490 that the additional information sheet pertains to. The builder should provide detailed and accurate information to ensure compliance with state regulations regarding custom-built or reconstructed vehicles.

Form HSMV 84491 is used as a supplement to Form HSMV 84490 when the provided space is insufficient to fully describe the assembly or reconstruction details.