Does this molding use the factory tailgate bolt holes?

Yes. This mounts directly at existing OEM attachment points — no drilling or fabrication required.

Will I need to paint this before installation?

The finish is designed for bolt-on installation as-is. If your tailgate has been repaired or repainted, test-fit first to confirm color match with your truck.

What's the difference between this and the molding with the step?

This version eliminates the integrated step feature, giving your tailgate a flat, seamless profile. If you use the tailgate step regularly, the standard molding with step may be a better fit.