HomeMy WebLinkAboutVehicle Title_Car_06/12/2000_Vin2871•
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IIGCHK33FOYF502871 12000 CHEV 4D I 6235 81144848
REGISTERED OWNER DATE OF ISSUE
VILLAGE OF TEQUESTA 06/12/2000
PO BOX 3273
TEQUESTA FL 33469-1004 LIEN RELEASE
INTEREST IN THE ABOVE DESCRIBED VEHICLE
HEREBY RELEASED
BY
MAIL T0:
05/16/2000
WESTERN BANK OF CHINOOK
DRAWER 9
CHINOOK MT 59523
DATE
TITLE
S4iISFOCTORV PROOF OF OWNERSHIP HAVING BEEN SUBMITTED UNDER SECTION 319.23/328.03, FLORIDA STATUTES, TITLE TO THE MOTOR VEHICLE
OR VESSEL DESCRIBED BELOW IS VESTED IN THE OWNERIS) NAMED HEREIN, THIS OFFICIAL CERT iF ICA"IE U(• IiiLE IS ISaUtO
FOR SAID MOTOR VEHICLE GR vESSEI
IDENTIFICATION NUMBER YR, MAKE MODEL BODY W7-L-BHP VESSEL REGIS NO. TITLE NUMBER
1GCHK33FOYF502871 2000 CHEV 4D 6235 81144848
PREY STATE COLOR PRIMARY BRAND SECONDARY BRAND NO OF BRANDS USE' PREY ISSUE DATE
N WHI PVT
ODOMETER STATUS OR VESSEL MANUFACTURER HULL MATERIAL PROP DATE OF ISSUE
60 MILES 05/16/2000 ACTUAL 06/12/2000
REGISTERED OWNER
VILLAGE OF TEQUESTA
PO BOX 3273
TEQUESTA FL 33469-1004
1ST LIENHOLDER
05/16/2000
WESTERN BANK OF CHINOOK
DRAWER 9
CHINOOK MT 59523
DIVISION OF MOTOR VEHICLES TALLAHASSEE
~ ~~ FI,ORiDA
7 ~
~~
WILLIAM T. JOYCE
DIRECTOR
LIEN RELEASE
INTEREST IN THE ABOVE DESCRIBED VEHICLE IS
HERF~-BY RELEAS D a
BY ~ ~ ~iiC ~~~%~~
~,f,~7~J--'C'~~~ ~ ~ ' r - 0 ~-
TITLE DATE
1 r ~ 4 ~~ 7 L f ~ 'hl
L I'J I J~~ J f J~ ~!J'J~~ 1 J 1
~~ ~ J ~ J ~ JF~ J ~ J J 1J1 J ~ J ~J J ~ J 11
TRANSFER OF TITLE BV SELLER
ODOMETER CERTIFICATION - Federal and state law require that you state the mileage in connection w~ih the transfer of ownership. Failure to
complete or providing a false statement may result in fines and/or imprisonment.
This title is warranted and certified to be free from any liens except as noted on the face of this certi?icate and the motor vehicle or vessel described is hereby trans ferred to:
Purchaser: Address
Sell',n; F'rice: $ Date Sold:
1/We state that this 5 or ^ 6 digit odometer now reads ~~^,^^^ .xx (no tenths)
miles, date read and to the best of my knowledge CAUTION ~ i. I hereby certify that to the best of my knowledge the odometer reading reflects the
that it reflects the actual mileage of the vehicle described herein, unless DO NOT CHECK amount of mileage in excess of its mechanical limits.
one of the odometer statement blocks is checked. BOX IF ACTUAL ^ 2 I hereby certify that the odometer reading is not the actual mileage:
MILEAGE WARNING - ODOMETER DISCREPANCY.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Signature of Printed Name of
Purchaser: Purchaser:
Signature o Printed Name of
Co-Purchaser. Co-Purchaser.
Signature of Printed Name of
Seller. Seller.
Signature of
Co-Seller: Printed Name of
Co-Seller.
(When Applicable)
Taz Collected. $
Selling Dealer's License Number. Tax No.
_
'~ Auction Name License Number.
g =
II ~ ~_ _. _.... ..... _. .. ._. _. _ _.___ _. _ _..... ..__.___ __..... _....._._ ___ ~~
..~.--~~E~63
FRED O. DICKINSON, III
EXECUTIVE DIRECTOR
sTATF of FLOa~~
LIEN SATISFACTION
MOTOR VEHICLL-S AND MOBILE HOMES
SECTION 319.2-1u)IBI FLORIDA STATUTES, PROVIDES THAT UPON THE SATISFACTION OF A LIEN. THE LIENHOLDER WILL, WITHIN TEN DAYS,
COMPLETE THE SPACE PROVIDED ON THE CERTIFICATE OF'FITLE. DETACH THE COMPLETED LIEN SATISFACTION AND MAIL IT TO THE DEPARTMENT. IF THE
CER ~'II'ICATE OF TITLE WAS RF.,T.41NED BY THE OWNER, THE OWNER WILL, WITHIN FIVE DAYS OF THE SATISFACTION OF LIEN, DELIVER THE TITLE TO THE
LIENIIOLDER. THE LTENHOLDER WILL ENTER THE SATISFACTION IN THE SPACE PROVIDED ON THE FACE OF THE TITLE. IF THERE ARE NO ADDITIONAL
LIENS SIiOWN ON THE TITLE. THE LIHNFIOLDF;R WILL D[iTACH THE COMI'L,GTED LIEN SATISFACTION, AND FORWARD IT TO THE DEPARTMENT. WI'Ih11N TEN
DAYS. AND MAIL THE TITLE TO THE OWNER.
SECTION 319.24(SI(C) FLORIDA STATUTES. PROVfDES THAT IF'I'HERE ARE ADDITIONAL LIENS NOT SATISFIED, A LIEN SATISFACTION NOR THE
FIRST' I.II'.N' ~ti'll.l. BE GIVEN TO THE REGISTERED OWNER BY THE LIENHOLDER. THE CERTIFICATE OF T[TLE SHOWING A SATISFACTION OF THE FIRST LIEN
WILL BI{ PORti'ARDED BY THE LIEMIOLDER TO TFIE DEPARTMENT.
VESSELS
FOLLOWING SATISFACTION OF A LIEN. THE LIENHOLDER SHALL ENTER A SATISFACTION THEREOF IN THE SPACE PROVIDED ON THE CERTIFICATE
OF TITLE AND WITHIN 3b DAYS DELIVER TI1E TITLE CERTIFICATE TO THE REGISTERED OWNER OR SUBSEQUENT LIENHOLDER. THE ATTACHED LIEN
SATISFACTION SHOULD BE COMPLETED AND FORWARDED TO THE DEPARTMENT.
Department of Highway Safety and Motor Vehicles
Neil Kirkman Building
Tallahassee, FI 32399-0500
t IU(,\II:'I F:I( Ct: R"PI PII'A'1'WN - Federal and sLdr bars require mat )uu slab the mileage in cnnneciian with lr:msl'er of o.. nership. Failure to complete or prvwidinR a false statement nms nsull in fines and/or imprisonnu•nt.
ticllinR Dealer's Dealer ids Tax
~ License No. Name Na. Collett d
ticflinR (baler's ;lddress
I/tVe ..anv,a ma tiuc nna cenin mat the vehicle. drerrcbrd herein has neen tmn.R•rred on nano ar the folbwinR:
~ N:m,rlal: aaarepp:
_ I(lV,. srar~ that Ili . ^ i „r I~ n li ail oJrr nrte, n~~u ra•aJ~s~
~ ^
I ~ »tr.i I I 1 -•. 1
t I r d h 1 I k t I I d ~I r retluts the actual mdeaee r,f the
,
L
nc r a
1~ :I. J,.~ h~Jt_t rlc.s., Jc neater Lila n: t111r cks r. ih,akW.
i. r t
r
C'AC'1'1()N: UO N()T' CHF.CI( ~ I_ I 1 x.hy iett'Iv rh.t t ~ the- hc.r r 1 na Arc wladyu rte r,Jonn~.r~ - i War„ [ I hveh asa irv that the d at~r rtia f rot iha acn,al ntdea¢e.
RO\ IF AC'r11A 1, r tr r: nc~ arrtr I l I avc ,n excess of rt 1 tp_i.,),I,_I, ills,,;. WARNINI: - OI)()11C1 f.K DISCI3I r ANl:1'.
~
u Si en:rrun• nl Pri»Iad Nuitre. »I
1'urehascr: I°Iltehast'r:
rJi (',t-Purchaser. Co-I'tu'chxser.
_ Scller/A;•enn Scller/r\~~cna.
Aurti~,n Nemc 1N'hcn :\pplicahlc n. L11.'ell~i Nunrher`
ticllinR Uealcr's Dealcr'.c Tax "tax
_ l.icrnse No. Name No. CMlected
ticllinR Uwacr's .-\ddress
_ 1/tVe warrant this title and cerlifr that the rchicie described herein has been transferred on rdatcl to the following:
N'amal sl: Address:
= I/N'e .;err rh,N rh + ^ ~ ur ^ 6 Ji~=r rxlomerer oo,e' rc. Js~
~ ^ f ~ h.l I - J'r I tJ t tl I r f t k ~I' Jt. d:l r reRecls (hr actual nnleaer r~l tl,r
r '
,.~h .I, Jes I J ha'a rn, nk.-. .. tr nc~ td meter ratan. nl lk..k: a. ahcs.k. J.
m
F C'.\C'fION: HO NI)r l'H ECIi ^ 1. I I achy u' ifV rlwr rn he hest ( .v kn<tsla I c I a r~J~ » cr.l ~~,~ ._ I beech ac 1af'y rhm h for itrr ru I' uol the vctual milea¢e.
RON IF 1CTCAL r Il tie. tha . nxsu rr nt n Ic: t.a sal rt; 1 toical ~hmrl.s. N'.4 RN'ING - ()Dt1A1I:'1'GR DItiC'RFI'ANCI'.
nul.Fau:E '
i
C Si,rnarun~ of I'rinreJ Namc of
i Caa-Purchas.~r. Crr-Purch:uer:
Scllci%Aprnl. Sclleil4ecnr.
_ :\ucm an Nance i Whev Al,l,llaablel- Licx•.nse Numner:
m s<ahnR oealer•.. Dealer,. Tax rnx
Limnce Nn. Name No. Collected
Selling Uealerb :\ddress
Invr ,.arrant mi. due amt trace mat me veldrte de,rdnetl nerein hax are„ Iranpirrrea on laaa•a to me rnnaw~ing:
!Vamelsl: Address:
- ~ ^ I I ~ I i r ',1
I 1 th M. t I k I I hart r cllecl.s the aeloel milcal~a• rrl the
IM .lure that the. ^ : ,r ^ fi J~gn nJo , tt r a ruuls~
` r ` a`
~.li ~I. ,I« a I,~J h~ ~.~ n I... I tl ~ - J a I I,~c A. a. nl c~:A~J.
.
~ l':\Ir'rION: U() N(Ir C HECN L% I. 1 I h' 11 tl I r rl I I \ k I J II ~. I t I ,. u 1 he'eb} tit that Ih 1 r na ( un me actual mdeaee.
- 131)N II• AL rllAl, r II ors tha unu a r r (n laaka _ee~s of ,l ,echamcal Inn fs. WARMNU - ODUM111, ILR DItiCIthl ANCY.
'z MII.N;A(.h;
Signamic oY PrimeJ Namc of
'
a Purchaser 1
urrhasa°r.
'
C
r,-Purchaser. cl~-Purchaser.
= SellerlAgenr. .Scller/e\_av.
_ Anerna~t Name Ita'neaa :\pPllcvhko-. Lieen>.• vmrtner.
NI)'IT('E: SIII.INI 1'F:NAI:II' IS RE()LI RF:D R} 1_A N' IF N()'f tit: it'A II'1-IT:D F()R TRANSFF,R 44'll'H I\' 111 UAV'S AFTER UA"rF: ()F' PCRCIi.AJF:
i make application for a new certifcan• of tide anA rcgis(rniinn Irvnst'rr, if appticahlr, 1'or paid motor ,'chicle or .rsscl ..high now has licwc as follows: Ill:ne. name and address of each lienholder. If NONE, write. N()Nk: t. Record additional liens
m Furm HNM\' %2139. F'EIINf nr FL/D[.p and Dale of girth
Liennnlnerp Name: D:ae nr Liea:
„Yj ,\ddrrs3 $lale Lip
fNlti VI IIICI.F, \1'II L BE CSF'D AS J 7 C111'A 11 I r PI )I.I('t: l'AR f"' 1.1;,\tiED [ PRI\.1'1'E
(_] I/tVF. }II;REI3V Ci;R1'IFV I'HA'r THE: VI.HI( I.I: 'r0 RF. 'rl"1'I.1?U t1'II.1, NO'r RE OPt:R1 TED ON I IIF. PFRI.IC' HI(:Htt 4Yti OF'CHtS STA"IE.
~ I/V.e .tale th I Ira. 6 Jtir ,~Jo .ter ar a ra< Is ~ I .the 7 t 1 d i I I 1 k I I{. U'rl t regrets the actual milutee cal the
~i,t~ r ~
~
,
vchial. Jearl aA h,. _a ttkss rr~af rl rJr nt tr srua»arr (k ak: rs rhaaked-
l'Al1'1'ION: Ilfl NI IT CHECK ^ I. I I archv cairify Ihar a~ nc~ bast t I' my kn.. tleJne the auh~ ne ~ rradn= ... _. I beech . rly ih; t6. J , eclat n; f - nd the actual note nee.
RO\ IF AC"1'ilAl. r Il r. I r amm ar of n~la: ge in excass of its mtthameal lin,rls. WARNINI: - 000111? 1 F:R DISC Ri:I'ANl':1'.
rou1,EACE
z
C
'~
II'KIN'I'fI'VI'1? NAME (/F PC:R('HASF:RItiI IDI•;N'17CA1.1,1' :\ti S((:NFD RF.LO\V'r NOT(?.: When faint ownership. please indicate "or" nr "and" nciween names. If no indication. "and" sill hr shown.
M1LVII.IN(. ,-tUDRESS CFl'1' ti'I'-1~fN. LII'
P11V"SIC:\I. -ADDRF:Sti CI~PV S'r:1TF: LIP License Plate Na.
CNDI'R YEN;1I:IlF:S OF PI:RII'RV', 1 DECL:I RE TII:\'1' I H:\t'1: KF.AD T11F: FONT(:OIN(; DOCC MF_N'f AND 'fII.1T 'fNl', F 1C'1ti 5TATF;D 11 IT ARE 'rRC'I!.
tiignalun• of Isi Purchaser
_
IFv:i Name. Vhadlr Initial. (.apt Numc! _: FI- NtSIDt~N'r f_ NON RI•;SIDI':NT L. ALIEN (Florida DIdJ or 1'1?IINf1 IFies[ Purchaser's Deic of Ririhl
Sign:dure• or ('o-Purchaser
lF st Name. !lhddle Inriivl. I.asl Nvnwl ^ FI. NESII)ENT' r' N'ON RESIHt:N1' ~ ALHiN 1Flnrida DI.N nr FF:ID#1 (tiecond P haser's Dn(r of Ririhl
OVGi Jo
~~CL rt
1GCHK33FOYF502871 2000 CHEV 4D 6235 81144848
REGISTERED OWNER DATE OF ISSUE
VILLAGE OF TEQUESTA 06/12/2000
PO BOX 3273
TEQUESTA FL 33469-1004 LIEN RELEASE
INTEREST IN THE ABOVE DESCRIBED VEHICLE
HEREBY RELEASED
MAIL T0:
05/16/2000
WESTERN BANK OF CHINOOK
DRAWER 9
CHINOOK MT 59523
(~~
~~~
DATI
TITLE
,., s ,.,
+~ t ,t~e~ ..~. s. ~~'•~'.,..~es^.°" s as: s ss. s, _ E.\!i . ~ My 'mo't ~~-' "''ii D~ ~ ~ I"1~~=ae: s~~u!~.~tr~t, ~~u..:'~:IcE
S 4TISF4CTORV PROOF OF OWNERSHIP HAVING BEEN SUBMITTED UNDER SECTION 319.23/328.03, FLORIDA STATUTES, TITLE TO THE MOTOR VEHICLE
OR VESSEL DESCRIBED BELOW IS VESTED IN THE OWNERIS) NAMED HEREIN, 'PHIS OFFICIAL CERTiFIC.4TE Uh Iliit a IaaUEtJ
FOR SAID MOTOR VEHICLE GR VESSEL
IDENTIFICATION NUMBER VR. MAKE MODEL - BODY WT-L-BHP VESSEL REGIS NO. TITLE NUMBER
1GCHK33FOYF502871 2000 CHEV 4D 6235 81144848
PREY STATE COLOR PRIMARY BRAND SECONDARY BRAND NO OF BRANDS USE" PREY ISSUE DATE
N WHI PVT
ODOMETER STATUS OR VESSEL MANUFACTURER HULL MATERIAL PROP DATE OF ISSUE
60 MILES 05/16/2000 ACTUAL 06/12/2000
REGISTERED OWNER
VILLAGE OF TEQUESTA
PO BOX 3273
TEQUESTA FL 33469-1004
LIEN RELEASE
INTEREST IN THE ABOVE DESCRIBED VEHICLE IS
HERFr$Y RELEAS~D a
BY .'Y' ~~ Ott ~(./}`,1~~~'u,-,
TITLE DATE
1ST LIENHOLOER L "+ + ! +' !'t7r !' +' ! ! +
+ + + + + + + + + + + +
~
05/16/2000 ~ + + + + + + {+ + + + + + r
WESTERN BANK OF CHINOOK + + + + + + + + + + + + +t
DRAWER 9
CHINOOK MT 59523 + + ' ti + + t I + + + +
'
~± ~+ ~ ~ ~ ~
'
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y
~
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~
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DIVISION OF MOTOR VEHICLES TALLAHASSEE
~'~ FLORIDA DEPARTMENT OF HIGHWAY SAFETY
~
AND MOTOR VEHICLES
'
, I~I±~'
~ ff ~~~~~~ ~~~ ~
~
.,,,~r~~l r.,r~,~~ ,,
WILLIAM T. JOYCE FRED O. DICKINSON, III
DIRECTOR EXECUTIVE DIRECTOR
TRANSFER OF TITLE BV SELLER
ODOMETER CERTIFICATION - Federal and state law require that you state the mileage in connection with the trznsfer of ownership. Failure to
complete or providing a false statement may result in fines and/or imprisonment.
Thls title is warranted and certified to be free from any liens except as noted on the face of this certifirate and the motor vehicle or vessel described is hereby transferred to:
Purchaser. Address
Sall;np Frice. $ Date Sold:
I/We state that this^ 5 or ~ 6 digit odometer now reads ~^~,^~~ .xx (no tenths)
miles, date read and to the hest of my knowledge CAUTION. ~ 1. 1 hereby certify that to the best of my knowledge the odometer reading reflects the
that it reflects the actual mileage of the vehicle described herein, unless DO NOT CHECK amount of mileage in excess of its mechanical limits.
one of the odometer statement blocks is checked. BOX IF ACTUAL ^ 2 I hereby certify that the odometer reading is not the actual mileage,
MILEAGE WARNING - ODOMETER DISCREPANCY.
UNDER PENALTIES 0'r PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Signature of Printed Name of
Purchaser: Purchaser.
Signature o Printed Name of
Co-Purchaser: Co-Purchaser.
Signature of Printed Name of
Seller Seller.
Signature of
Co-Seller. Printed Name of
(When Applicable) Co-$eller
Selling Dealer's License Number Tax No. _ Tax Collected. $
Ci
~.~ Auction
ame
License Numbe: .t~~
N
STATE OF' F'L<)KN~
LIEN SATISFAC"PION
MOTOR VEHICLES AND MOBILE HOMES
SECTION 719?-IIiI;BI FLORIDA STATUTES, PROVIDES "I'H,4T l!PON THE SATISFACTION OF A LIEN. THE LIENHOLDER WILL. WITHIN TEN DAYS.
COMPLETE THE SPACL- PROVIDED ON THE CERTIFICATE OF TITLE, DETACH THE COMPLETED LIEN SATISFACTION AND MAIL IT TO THE DEPARTMENT. lF THE
CERTIFICATE OP TITLE WAS RETAINED BY THE OWNER, THE OWNER WILL. WITHIN FIVE DAYS OF THE SATISFACTION OF LIEN. DELIVER THE TITLE TO THE
LIENHOLDER. THE LIENHOLDER WILL ENTER THE SATISFACTION IN THE SPACE PROVIDED ON THE FACE OF THE TITLE. IF THERE ARE NO ADDITIONAL
LIENS SHOWN ON THE TITLE THL- LIENHOLDER WILL DETACH THE COMPLETED LIEN SATISFACTION. AND FORWARD IT TO THE DEPARTMENT, WITHIN TEN
DAYS. AND MAIL THE TITLE TO THE OWNER.
SECTION 319?-t(SIIC1 FLORIDA STATUTES. PROVIDES THAT IF THERE ARE ADDITIONAL LIENS NOT SATISFIED, A LIEN SATISFACTION FOR THE
FIRST LIEN WELL BE GIVEN TO THE REGISTERED OWNER BY THE LIENHOLDER. THE CERTIFICATE OF TITLE SHOWING A SATISFACTION OF THE FIRST LIEN
WILL BF FORWARDED BY THE LIENHOLDER TO THE DEPARTMENT.
VESSELS
FOLLOWING SATISFACTION OF A LIEN, THE LIF,NHOI,DER SHALL ENTER A SATISFACTION THEREOF IN THE SPACE PROVIDED ON THE CERTIFICATE
OF TITLE AND WITHIN 30 DAYS DELIVER THE TITLE CERTIFICATE TO THE REGISTERED OWNER OR SUBSEQUENT LIENHOLDER. THE ATTACHED LIEN
SATISFACTION SHOULD BE COMPLETED AND FORWARDED TO THE DEPARTMENT.
Department of Highway Safety and Motor Vehicles
Neil Kirkman Building
Tallahassee, FI 32399-0500
ODI I\Ii. I'F;I( ('I?R'1'IFIC.\'1'101 -Federal :mA st.;Ie law. rcyuire Ihat you stale the mileage in cnnnrcliwn seilh Ir:;ns'frr ..1' ownership. Failure Io complete nr providing a false statement may result in fines and/or intprisanmenl
~ Selling IIe:Jcr'.s
I.icrnse Nu. Dealer's 7'ax Tax
Name Nn. Collected
~~i Selling Drala•r'v AAtlrrxs
u I/We .van am Ihix lute vnd merit\' that the vanicle tlexcribrd herein hux htt:n Irane'Cen'ed un Idalrl la the following:
N
Nanu'G 1:
Address:
I/VVa sn to that thi+ f, dot ocl
- ~ ` ..r n omcvet nms tea 1+ ^ I I d. I I t d . nl to tl h t ( y k I 1- d at t reHerts the actual mdeaec of the
~
~
_
m
C'AI''f10N: DO NOT 1,'HFl'K aJ I- .
vehivh Jc . I e.J hara' t. t tlar.: uta t 1 he stdnntrter +t. to lna tl hlccAS t+.heckaJ-
I ] -aby aertity that to the Ixst t n~ k tuwladl. the c d. n cad n [] ?. i h. rch .a nil)' that th I n rt, d ~ not the actual mileage.
s
It0\ IF \C'Clt;\t. ntl t- tl r amqu t f 'leugc %cess of it' h n1a,J I nix. W,\RNIN(; - ODO\1LCCR DISCRCPANGY.
nu1.F:ncF:
L Sicnatun~ nl
1'urc~aser: I'ri ntad Nanta of
I'u«hoscr:
s Co-Purchaser- Co-Purrhmcr.
Sadler/:\gent. Suilct/Agent.
Aualitm h;xnte Mhen Applicable r. I.iccnse Nunnc~f:
Selling Uea!e,'s Dealer's 1':;x Tax
-_ License ln. lame No. Collected
Selling Ueuiert Address
1/\Fe w:vr:ml Ibis title and certify that the v ehicle described herein has hero trnnsl'ernvl nn tdaa•I hr the following:
lanxssl: Address.
= i/w' r • ;hat this ~ ~ or ^ F iigit rxl ometar now reads
~ ~ t f h t I J t J
~ d t th h': i i • A -. I d ter retlects the actual mdeaec of the
'
nc
vehicle de s-6a I harcin, 1 ~ of th .d-roarer :tatament ptoeks t, checkad:
t-
C.\t'"PION: DO NOT CHE('1( ^ I.
1 h. 6v cenity that n: the hc+ ( tv knnwlcJ,a tha odttntater wadi tg ~ ?. I hercb ~ ~rtif) that the odometer reading is not dre actual mdeaue.
y BOr IF A('Tl'AI, reFlects the amount of mikxga in excess of its mech:rnkal IimiLs. WARN{N(; - ODO\1F.TER DISCREPANCI'.
~ nu1.Ex:E'
Sicn.uurc of Pmm~l Namc of
I'urcila.vr- Purchaser.
i Co-Ruchusai. (:o-Purchaser.
Srilrr/Agutt.
Auction Namc twhcn ApplicuFlc t: $clicr/Aecnl:
Cia,- sc Number
~ Selling Deaim''s Daaler's 'Cox Tax
_ I,icensr Nn. Name No. C'olleclyd
2 Jelling Dcnlcr'sAdJnw.s
0 1/VVe warrant Itlis title and cerlil'y drat the v ehicle described herein has been Irunsti•reed on Idatrl to ihv following:
z, Namefs): AJdmss:
_ I/N siwa that th4x t, Ji it od
^+or^ g or rcret new ~eads~ ~ t 'f tl I I f t :rd I t [h h t t ~ k I 1 a the [ 'r retteces the ' lnal mJaaec tbl the
' A ~ '
~
l'All'ITON: DO NOT ('HF;Ck LI I. .
t.ah rlr Jt~..r. haul ht of li++u~ It dt t+a r.nt Ikck. tb:.kaJ:
I I e:abs sari fv thut t, tha hest of n)• A ttt;t laJ;.v tha odoma - -aad nr ~ J _. 1 hcreh + t ify that thv r J t aaJ' not the acntal miletee,,
ICON IF A("CI,IAI, t f'I st, the amat nt ..I' nilcx~c tis of itv mcrhaoiral lin»Ls. WARNIN(; - ODl)'N f; fLR D15C'RF.PANCl'.
MII.N:AGF
- Signa a of Printccl N:rnta of
Purch:~rr: Purchasm':
~
z Ctr-Purchase i. ('o-Puralno.ai.
=
`~ Seller/Aeenr.
Ax~lnm N:une !N'hcn Applicable r. Grllcr/A,~cnt.
l-ic~•nsc Numhcr.
N O'fICE: SIfI.UII I'ENA I: CY IS RE(jC'IR7?I) B}' 1...-1 VV' IF NOT SI!IS V11'I"fEU FIIK 'f1iANSFI:K WI77{IN ell UA\'s AF"1'ER U,\TF. OF' PC'RC'.HASE
I make application far a new certificate nl'titl c and regfstratlon transl'rr, if applirrble, 1'nr said motor vehicle ar vessel which now bus Iirns ns Cullows: (Dote, name and address of exch lienholder. If NONE, write NONF:1. Record additional lie;w
rn Form 1{tiVl\' %?134. F'}:IINf m F'I.l111~# and Detc aP Birth
I.ienhulJer's :Namc: Dale of Lien:
~~ Adder.., state rep
'CHIS \}HICI.F; WIl 1. Rf: t.S};U ,\S
1/\\''1 HERF,ISY (};R'17F}' THAT THE r' TA\ICAB PUI.I('E C 1K 1 11':.\SLD : 1'KI\'-1'fi~:
\ LI{IC I,I': 7'O It F: 'CI'1'LF:D ~IVILI, 10'1' Itl•, (II'I:K•\'1'1':U Oh TIIE PLBLIC HII:HN \}S OF"CRIB J'C,\'1'E.
.~~- I/AV:.tatc the t th + 6 diC,it oJ
~; or~ o r r noa rcads~
~ ~ 1 '1 U I I d ~ 1 t. h ba. M • b '1 d i at it reDcets the actual mileaxe of the
,
vchiclt dc+t. -thud hua t. rnlrns ane of th td<mc ur :talemrnt blacks is checFed:
(::\L770N: UO NOT ('HECA ^ I. 1 h by cenif~ that to th< he.t of m+ k to+; Icdgc iha odt+m.• cr rcudt r, __ _. 1 herchv -rtily that the odometer reaJin; rs not the actual nnleaee.
_ ISO\ 1}' ACTUAL
AIII.EA(; t: r fl - x the umonm of miiea__r s nl' itmrchamrui i~mfis WARNIN'(; - OD(» 1ETER DISCRLPAtiCi'.
z
z /VNI~\''C!i'YPF: N.-\,\1F OF I'C RCH.1tiF.RtSr IUE~TI('ALI,I AS til(;~FD KF:1.0\V'1 \OTF: N-hen joint oonerhip, please ;ndic.Ne "ar or and between mm~es. If no indtealion. 'and` will be shown.
VLVLING -ADURF.SS CITY STATE ZIP
YHV'SIC.V. AUUHN:SS ('CCY' STATE '7.IP License Plate Nn.
(INUI!R PF:N.\I: I'II•:S OF {'F,RdCRV, 1 UF.C I.A RF: THAT I HA\'1? READ THN: FORE(;OI\(: DO('L VII?N'f ANU "C11:\T 1'HF: F 4l'IS A'i'ATF:U IN 1'T ARE TRCE.
Sigmdura• of Ixl Purchaser
tF .I Namc, diddle Initial Last Namrl PI. Ki;S IDF:\'C [] NON RF.SIDF.N'f [~ AI.IF;\ tFionda UI.# ur FF.II)#1 IF'irvt Yunhx.scr's Date nl' Itirthl
Signature of ('o-Purchavcr
I Firs) lame. }{fiddle htilial, las! Hamel L Ff. RFSIDEN'C [~ NON RF;SIDF:N'I' [) AI.II;N (Florida DL,#or FEIITYI ISecand Purchaser's Dade of Nirthl