Will this step work with my hitch if the receiver is mounted at an angle?

Depends on the angle. Test-fit it first — if your receiver sits level when loaded, this step will sit level too. If your receiver is angled more than a few degrees, the step may sit pitched, which affects footing safety.

Does this come with bolts and fasteners?

The step assembly is confirmed — fasteners are not specified. Bring your own bolts rated for hitch loads, or ask your installer what size your receiver requires.

Can I repaint the chrome or use this unpainted?

Chrome is applied as a finish — it's not a base coat. If you want to strip and repaint, you'll need to remove the chrome first. Running it bare chrome works fine if you're okay with maintaining the polished look.