[Iowa DOT] 420054. Affidavit to Operate a Vehicle for Inspection

Completion of this form constitutes a permit to drive or tow the following described vehicle to/from a vehicle inspection location without registration plates. This inspection will be conducted by the Iowa DOT Bureau of Investigation & Identity Protection.

do hereby certify that the following vehicle

is properly equipped and in a reasonable safe condition to be operated on a public highway to and from

for the purpose of a vehicle inspection.

This affidavit is valid only for the described vehicle and date and must be carried in the vehicle. Improper use of this affidavit is a violation of Iowa Code section 321.17. Law enforcement may verify the validity of this affidavit by contacting the Iowa DOT Bureau of Investigation & Identity Protection at (515) 237‑3050.

This affidavit is issued pursuant to Iowa Department of Transportation Administrative Rules 761-400.13, 400.16, 400.51 and 405.15. Compliance with Iowa's financial liability coverage law is the owner's responsibility.

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