HomeMy WebLinkAboutVehicle Title_Car_12/22/2009 Mail Lien Satisfaction to: Dept of Highway Safety and Motor Vehicles, Neil Kirkman Building, Tallahassee, FL 32399 -0500
Identification Number — Year Make Body r -L -BHP Vessel Regis. No. T Title Number —
L FAEIPM21AX114797 �2010�FORD� 4D W 4005 1 1 03557001 03557001
Regislercd Owlier: Date of Issue 12/22/2009
Lien Release
VILLAGE OF TEQUESTA Interest in the described vehicle is hereby released
By
i' 345 TEQUESTA DR
I ' TEQUESTA FL 33469 Title
Date
IMPORTANT INFORMATION
1. When ownership of the vehicle described herein is
transferred, the seller MUST complete in full the
Transfer of Title by Seller section at the bottom of
Mail TO: the certificate of title.
2. Upon sale of this vehicle, the seller must complete
VILLAGE OF TEQUESTA the notice of sale on the reverse side of this form.
345 TEQUESTA DR 3. Remove your license plate from the vehicle.
TEQUESTA FL 33469 -3062 4. See the web address below for more information and
the appropriate forms required for the purchaser to
title and register the vehicle, mobile home or vessel:
�n��llrlllr�u�r��rl�l�nrl��l� 'eur��rullr�t�lr�r�l�rrlr�t� http:// www. hsmv .state.fl.us /html /titlinf.himl
ldeglficahon Number Year M'aka Body Wi L BHP : Vessel Regis No :. Title Numtrer
' I �l me Release
2ABP?BV3AX114797 2010 FORD 4D 4005 10355 i Interest ,the desenbedvehicleis hereby release d'
C S tate Color P[mary 9rantl Secondary Brand. Brands Use Prev >Issue Date By
,N LK `P RIVATE Title
Odometer Status of Vessel Manufacturer or OH use Hull Material Prop pate of Issue
4 MILES 12/15/2009 ACTUAL T 12 /22 /2009
Keg),Iered O�c�icr
VILLAGE OF TEQUESTA
345 TEQUESTA DR
TEQUESTA FL 33469
1 sl Licnholder
® NONE
OI
/+i?if•
DIVISION OF MOTOR VEHICLES TALLAHASSEE �� 3\ FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
�'. °�
.
Control Number 0 9G 20634
0
Carl A. Ford Julie L. Jones
Director Executive Director
TRANSFER OF TITLE BY SELLER (This section must be completed at the time of sale.)
Federal ind /or stale low require that the seller slide die tnilege, purchnsers none, yelling price and dale sold in connection with die transfer otownership.
Failure lu cmnplele ur providing n fidye strtetnent mpg result in tines nndlur imprismunenl.
'Ittis title is w n-nled to be free h'unr any liens except: noted un the face oflhe certificate and the motor vehicle or vessel described is hereby trntsterred to
Seller Most Filter Purch,, IsNarne• Address:
Seller Musl Fnler Selling Price Q1 a _ _- _ Seller Must Fader Dole Sold' _ q
1 /We slide Ih;d prix [mo'' orE] 6 digit odometer now reads IR I IA I _5I 15I_II_ JX j (no Icnlhs) miles, dale read _.Q I VJ J JLe cold 1 hereby certify that to the best o1 ny knowledge the odnneler retaling:
Imo '. rutlecls ACl'k)AI. MILEACIE. 171 2. is IN F,XCI?SS OF ITS MECHANICAL LIMITS. E] 3. is NOT THE ACTUAL MILEAGE.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
SFJJ E Mill M�i I � � Cf n H erc• I I F•. Mnyl
Sign Hen 1 t � �C Sig
� / n H -
Inut Herc .,��r1 Mawl1(.rmj Vl'k��'�1 "� Print Hcru• _ -
: Selling F)oldir L,im i- Noutber. -_ "I'cue :Nu. - :... Tax Collected: -
:.._
YItRC HASI!R M it,
C.O - P,UkC'H \SI• R)vhsl
� r
' Pcihl HcN'e
tY IS,REGiU1RE`f� �Yi tr O SUgIWtTYCD FOR fiJtAtdSBER Y4fl [ Hly �0 Du ►YS AF 1 ER: BATE OF PURtt#i►SI=
P
1 1 Iff dh ® r ® 0
Roan
e
Tequesta Police Department, FL
357 Tequesta Dr
Tequesta, FL 33469 -3088
Bill of Sale Date: 02/17/2016 Bill of Sale Number: 2172016
Asset ID: 6 Inventory ID: 035
Description of Property Award Amount
2010 Ford Crown Victoria Police Interceptor 2175.00
Asset Information
Year: 2010 Make/Brand: Ford Model: Crown Victoria VIN /Serial: 2FABP7BV3AX114797
Meter: 94555 Miles (Accurate ?: Yes) Title Restriction: N
Sale Information
Actual Sold Amount: $2,175.00 Paid On: 02/18/2016 by Credit Card
Other Amount: $0.00 Other Amount Description:
Buyer's Premium: $217.50 Tax Rate: 0.0000%
Tax Amount: $0.00
Total Amount: $2,392.50 * Taxable Items
Cape Auto Connect Asset is sold as is, where is and without warranty. Once the asset is removed from the seller's premises there
1232 Viscaya Pkwy is no refund of monies p io ly paid.
Cape Coral, FL 33990
USA Buyer /Agent S' ure: Q
capeautoconnect @aol.com Print Name:
2394716649 Date:
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES - DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
www.flhsmv.qov/office
of Sale and /or Bill of Sale for a Motor Vehicle,
Mobile Home, Off - Highway Vehicle or Vessel
Notice of Sale (Seller must complete sections 1 & 3). The purchaser's signature in section 3 is optional.
✓ Bill of Sale (Seller and purchaser must complete sections 1, 2 (when applicable) & 3).
1. Motor Vehicle, Mobile Home, Off- Highway or Vessel Description
Year Make /Manufacturer Body Type Model Color
2010 Ford Crown Vi Crown Vi
Certificate of Title Number Vehicle/Vessel Identification Number
1 2FABP7BV3AX114797
I /we do hereby sell or have sold and delivered the above described motor vehicle, mobile home,
off - highway vehicle or vessel to:
Print Name(s) of Purchaser(s)
Cape Auto Connect
Address City State Zip Code
1232 Viscaya Parkway Cape Coral FL 33990
Date of Sale 2/17/16 Selling price .� l�S . 0O
2. Odometer Disclosure Statement (Required For a Motor Vehicle)
Federal and State law requires that you state the mileage in connection with the transfer of ownership. Failure to
complete or providing a false statement may result in fines and /or imprisonment.
WE STATE THAT THIS MOTOR VEHICLE'S ✓ 5 DIGIT OR 6 DIGIT ODOMETER NOW READS D E F a EI EI . xx
(NO TENTHS) MILES, DATE READ 2 / 16 / 16 AND WE HEREBY CERTIFY THAT TO THE BEST OF OUR KNOWLEDGE
THE ODOMETER READING:
✓ 1. REFLECTS THE ACTUAL MILEAGE. I 2. IS IN EXCESS OF ITS MECHANICAL LIMITS. 3. IS NOT THE ACTUAL MILEAGE.
Affidavit (When applicable):
3. Certification
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS
STATED IN IT ARE TRUE.
Seller's Signature Seller's Printed Name Date
' L Q/Y+� Lori McWilliams (for the Village of Tequesta) 2/18/16
Setter's Address City State Zip Code
345 Tequesta Drive Tequesta FL 33469
Co Seller's Signature (when applicable) Co Seller's Printed Name (when applicable) Date
Cape Auto Connect 2/18/16
Co- Seller's Address (when applicable) City State Zip Code
I
Purcha ers Si nature Purchaser's Printed Name Date
Cape Auto Connect 2/18/16
Co -Pur ase s Signatur (when ap ' bl Co- Purchaser's Printed name (when applicable) Date
6
OWNERSHIP STATUS FOR THE ABOVE DESCRIBED MOTOR VEHICLE, MOBILE HOME, OFF - HIGHWAY VEHICLE OR VESSEL
WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
Check your local phone book government pages or visit the following website for current mailing
addresses: http: / /www.flhsmv.gov /offices/
HSMV 82050 (Rev. 06/11) S
,IAIt Ul I
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTOR VEHICLES
Neil Kirkman Building - Tallahassee, FL 32399 -0620
Notice of Sale of Motor Vehicle, Mobile Home or Vessel
Section 319.22(2), Florida Statutes, provides that by tiling this form, you can avoid any civil liability for the operation of the sold motor vehicle, vessel or mobile Dome.
In addition to filing this form, we suggest you keep a copy of your bill of sale (we ,ugge;,t it be notarized). certificate of title or other type of transaction document showing
the vehicle was sold. Complete the information belovi, tear the top portion of this document at the perforation and mail to the address above or submit to your
local tax collector's officeor license plate agency.
��
I have this _day of_w/ , 2,01t, , transferred by assignment of and delivered Florida Certificate of Title to: a I (,��5, ,ADO
Name: Purchaser(s) CO- PLAu +o CcnneC -I _ Address ! a� ��3 I�SGI a 1 e 4Lpe- Selling Price $ a��
C(20 FL 3349
UNDER PENALTIES O PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Seller's Signature Az f ' )L' Qn'�` v I I Wk `) OL Co- Seller's Signature
NOTE: THE SUBMISSION OF THIS FORM, ACCURATELY COMPLETED, TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY OR TO THE
ADDRESS ABOVE WILL ALLOW THE TITLE CLERK TO UPDATE THE DMV DATABASE TO REFLECT THE TITLE RECORD AS "SOLD ". HOWEVER,
THE OWNERSHIP STATUS WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
C l o ve
fiIF to f° s
l�Y:L^IiT]IC\ j011 Ie anil sdlall f dtu )•ou sa f C n,�cEt >F'gst 4'a lyt.s�-useq,l }:lint 70 espnt 1 ttf or bg5ffiit S9 ieat It ht9 lit s5ud t t N
: Pt Er�D43tEer t. `etlin(, Dealers
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- CLI(TIFI I IIA TO TH f)t:Sl tr( 41� K".tJ�tk 1 Fl(;F.'fyI- Obt)tif Tl fi lt[:.1,1')kN(r
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CAUTION: READ CAREFULLY I. RG{- LP(TS \i - il'4L S!IC.b t[:f , 'Q? 15:1s F \t ESS OF [TS \11.1111 \1 1..i I?hil'S _ ❑;. >tS R[ }T IHT- :�(`IL AT. MItf \GF,
BEFORE YOU )FA(LSS (iF 1T_ }IE('11:1 \i<AL I..LsIIT S w% R! , f1N6 - ODOME IL;R UIS( RFI'A`tCl'
L - CHECK HECK A BOA AP L 11 S..to ; DMI F ODO�,IF. FFR,,
7 Purchaser Nfust Co- Purclm +er \fu.t
tF sigtrHerc • _. _ _
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Seller /Agent Must .Auction Name (Vi Applicable): -
Sign Here. )
POntliere:
Selling Dealer's Selling Dealer ; s
- -- - -- Tar Ta
License No.: - Name: _ _ - _ No.: - Collected:
W Selling Dealer's. Address: _ - -_ _. -_ _ ,... Date Sold:
L] Purchaser's Name(s): - _. - _ - _ _ _ Address:
v.
- 1!A4'I'. S'tATl: T FIAT tHfS 5 OR 6 D[C;I r 6U(JMET ER NOV• RI -ADS ;. � i " +t) I F` I H>) A1tI ES D.41 Fi READ : - _ , AhD I HFRI!.E3Y
( IiR7T. r 7HAl TO 1111 FIT Sl 11P MS KNON 1. t'.DGI PlIF: ODC7A1bPLR 1'ADINl7:
' p C- AI "r10Y: READ CAREFULLY � � L 10 1LP( LS cIt. AL ml( 13[ - �i � '_ 1, IA L 117SS OF t MI 11 .1C.XI -I I'll] IS I 1 3. IS NOT IIII. A( II'AL MI fAGI .
z BEFORE YOU I °.•l( I Sc, OF ITS AL I. H:. `,{[ sL 7 7M1 TS 4- � \A.aRKIN(r- ODU,gILTL.R DISC'RbPAN( ]
.. CHECK A BOX API'I IFS TO ; hill ODI)MF.I LRS)
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2 Purchaser Must Co- Purchaser \1tst
N Sien I[ere -. .. -. Sian Hcre•
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p Print I let.. P,;:!,
w Sellerl Agent Mu,t Auction \ante (w ben Applicabic):
Sign Hcre:
I\
Print F1 re'
u;tv 1 1Ce'r P;upth r:
Selling Dealer's , ,citing Dealer's Iax - Tax
i
License No.; Same: _ No.: Collected:
� Selling Dealer's Address: _ -- _. - -. -- ------ - - - - --
Date Sold:
Purchaser's Name(s): Address:
O �
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I/R IAll THAT
AT THIS 5 OR h DIGH ODOETER No',% READS '.,�• �. 01 (1,'O 1 I N I }1S) tiIIL E S. DAI F. Rf AI) _ ____.AND I HEREHl'
w CLRi!I1THATTOTHL,I.iESIO NINKNOwLBnGt 711FQUOMETLRRF':.ADING.'
C'.Al "Ilb \; READ CAREFULLY LL]' L_. REFI,ECIS AC'TCAL ? :ULt t4d '� lti 1\ E \C ESS OF 11.5 .I'r.(HANI('AL LIMITS 1, NOf lln pC IE kL;NfILFAGL -.
- _ - BEFORE VOU it. \Ct SS O>::�.II S Nl, C}{ANh AL L.1: \fITS A' ARNIN(r-.bDObfkBliR DI.SC'RRP.AN0N
CHECK A -:.
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w. . BOX •kPPt it S 1O PP,IT ODOMEI TERSj
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A04613
Mail Lien Satisfaction to: Dept of Highway Safety and Motor Vehicles, Neil Kirkman Building, Tallahassee, FL 32399-0500
Identification Number Year Make Body 11VT-L-BHP Vessel Regis. No. T103557001� Title Number —
2FABP7BV3AX114797�2010TFORDTT4DT 4005
Registered Owner: Date of Issue 12/22/2009
Lien Release
VILLAGE OF TEQUESTA Interest in the described vehicle is hereby released
345 TEQUESTA DR By
TEQUESTA FL 33469 Title
Mail To:
VILLAGE OF TEQUESTA
345 TEQUESTA DR
TEQUESTA FL 33469-3062
�n��nr��rr�rr�r��rr�r�rrn��r��rrrr��tnr�r�r�n�r�r�n�r�r�
0
Date
IMPORTANT INFORMATION
1. When ownership of the vehicle described herein is
transferred, the seller MUST complete in full the
Transfer of Title by Seller section at the bottom of
the certificate of title.
2 Upon sale of this vehicle, the seller must complete
the notice of sale on the reverse side of this form.
3. Remove your license plate from the vehicle.
4. See the web address below for more information and
the appropriate forms required for the purchaser to
title and register the vehicle, mobile home or vessel:
http://vAAiw.hsmv.state.fl.us/html/titlinf.himl
0
MIKA
;
TALLAHASSEE -,� � FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
Identification NumberYear — Make Body UUT-L-BHP Vessel Regis. No.
Title Number —
Control Number 0 9 6''%"2 0 6 3 4
Carl A. Ford
T
T1O3557001
Lien Release
2FABP7BV3AX 1 147972010
FORDI
4D
4005
Interest in the described vehicle
is hereby released
- P ev
Color
Brand Secondary Brand No of Use
Prev Issue Date -
By
-
State
TB
Brands
N
LK
7Primary
=
7
PRIVATE
Title
— Odometer Status or Vessel Manufacturer or OH use Hull Material Prop
Dte of Issue —
TDate
T T123/22/20091
4 MILES 12/15/2009 ACTUAL
Registered Owner
VILLAGE OF TEQUESTA
345 TEQUESTA DR
TEQUESTA FL 33469
1st Lienholder
NONE
DIVISION OF MOTOR VEHICLES
;
TALLAHASSEE -,� � FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
Control Number 0 9 6''%"2 0 6 3 4
Carl A. Ford
Julie L. Jones
Director
Executive Director
TRANSFER OF TITLE BY SELLER (This section must be completed at the time of sale.)
Federal and/or stale law require that the seller sate the alege, purcha sm's vane• selling price and date sold in connection with the tr:mst.r of ownership.
Fuilrve to complete or providing a false state cut may result in tines und/or inprisonnenl.
This title is wa rralkied to he free frronh arty liens excepl ac mated on the $hn. of the cerlitica is and the motor vehicle or vessel described is hereby h;nsterred to:
Seller Most F:nler P—haser'sNune: _ Address:
Seller Must Enter Selling Price: —,Seller Must hinter Date Sold:
I/We slat that this [-].Ior ❑ 6 digil odometer now reads 1_I _ j_ ,jJ _I _i.I-X I (no tenths) miles, date read mid I hereby certify that to the best of np• knowledge the edomctei mauling:
1. reflects A(711 Al, MILEAGE. ❑ 2. is IN F:XCFSS OF'rl'S MECHAMCN, LIMITS. 73. is NU"I' "IT -IF: ACRIAL MILE]\GE.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
SI-11F:R Mnsl C(1-SELLF:K Most
Sign Her.: _ .'l<_ _ -. Sign Her.:
PrinI He, ::-T— :"'. _._T T ;;.:... Print Here:
Selling Dealer's Li cem.N her. Tax No Tawe Collected:
Audi n Noiue License Ntnlhe,
PtrkCHASF:H Mua Co -PURCHASER Muhl
4
Sign. Hcic: Sign Here
Print Here: P
NOTiCE: PENALTY_ IS REQUIRED BY-LAW IF NOT SUBMITTED FOR TRANSFER WITHIN 30 DAYS AFTER DATE OF PURCHASE -
McWilliams, Lori
From: Yildiz, Emir
Sent: Thursday, February 18, 2016 10:59 AM
To: McWilliams, Lori
Cc: Wallace, John
Subject: FW: GovDeals.com Paid Notification
Attachments: BillOfSale_7075_6.pdf
Morning,
Asset 035 (2010 Crown Vic) has been paid and is now pending pickup. Can we have Mr. Couzzo sign the titles so the
gentleman can pick it up?
Once picked up, John Wallace will mark the item as "picked up" which authorizes govdeals to release the funds to us as
in the past.
Thank you
From: Leslie Moseley [ma i Ito: lmoseley @govdeals.com]
Sent: Thursday, February 18, 201610:55 AM
To: Yildiz, Emir <eyildiz @tequesta.org>
Subject: FW: GovDeals.com Paid Notification
Leslie Moseley
Client Services Representative I GovDeals.com
ImatthewsCcD-govdeals.com 1 (334) 322 -7174
From: CustomerService(&GovDeals.com [ mailto :CustomerServiceoGovDeals.com
Sent: Thursday, February 18, 2016 9:54 AM
To: Leslie Moseley
Subject: GovDeals.com Paid Notification
Payment has been received for the following asset. The buyer has been notified that the payment has been
received. They have been instructed to contact you concerning pickup of the asset. The buyer should present
you with the buyer certificate at pickup.
Please print a copy of the Bill of Sale (attached) for this asset and have the Buyer sign the Bill of Sale upon
removal, or you can log into GovDeals.net to print the Bill of Sale.
Thank you for using GovDeals.
Buyer: john regan (username: capeautoconnectkaol.com capeautoconnectkaol.com
The following asset is ready for pickup:
Certificate ID: 6- 0217161800 -7075
Asset ID: 6
Inventory ID: 035
Description: 2010 Ford Crown Victoria Police Interceptor
1
If you have any questions, please contact your Client Service Rep, Luciana Goreed at 904 - 238 -8797. Thank you
for using GovDeals!
2
McWilliams, Lori
From: Racanati, Tatiana
Sent: Thursday, February 18, 2016 11:25 AM
To: McWilliams, Lori; Mayo, Deanna
Cc: Telfrin, Debra
Subject: RE: GovDeals.com Paid Notification
Yes, it has been surplused Res 67- 159/10/15
Tatiana
From: McWilliams, Lori
Sent: Thursday, February 18, 2016 11:21 AM
To: Racanati, Tatiana; Mayo, Deanna
Cc: Telfrin, Debra
Subject: FW: GovDeals.com Paid Notification
Tatiana,
Please verify the sold vehicle has been surplused.
Deanna, when I get the bill of sale signed and give it to you to scan, is it in an accessible file for Tatiana to open?
Lori
From: Yildiz, Emir
Sent: Thursday, February 18, 201610:59 AM
To: McWilliams, Lori <Imcwilliams @tequesta.org>
Cc: Wallace, John <jwallace @tequesta.org>
Subject: FW: GovDeals.com Paid Notification
Morning,
Asset 035 (2010 Crown Vic) has been paid and is now pending pickup. Can we have Mr. Couzzo sign the titles so the
gentleman can pick it up?
Once picked up, John Wallace will mark the item as "picked up" which authorizes govdeals to release the funds to us as
in the past.
Thank you
From: Leslie Moseley [mailto:lmoseley @govdeals.com
Sent: Thursday, February 18, 201610:55 AM
To: Yildiz, Emir < evildiz @teguesta.or >
Subject: FW: GovDeals.com Paid Notification
.t
Tequesta Police Department, FL
357 Tequesta Dr
Tequesta, FL 33469 -3088
Bill of Sale Date: 02/17/2016 Bill of Sale Number: 2172016
Asset ID: 6 Inventory ID: 035
Description of Property Award Amount
2010 Ford Crown Victoria Police Interceptor 2175.00
Asset Information
Year: 2010 Make /Brand: Ford Model: Crown Victoria VIN /Serial: 2FABP7BV3AX114797
Meter: 94555 Miles (Accurate ?: Yes) Title Restriction: N
Sale Information
Actual Sold Amount: $2,175.00 Paid On: 02/18/2016 by Credit Card
Other Amount: $0.00 Other Amount Description:
Buyer's Premium: $217.50 Tax Rate: 0.0000%
Tax Amount: $0.00
Total Amount: $2,392.50 * Taxable Items
Cape Auto Connect Asset is sold as is, where is and without warranty. Once the asset is removed from the seller's premises there
1232 Viscaya Pkwy is no refund of monies previously paid.
Cape Coral, FL 33990
USA Buyer /Agent Signature:
capeautoconnect @aol.com Print Name:
2394716649 Date: 4jW
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES - DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
www.flhsmv.ciov /offices/
Notice of Sale and /or Bill of Sale for a Motor Vehicle,
Mobile Home, Off - Highway Vehicle or Vessel
Notice of Sale (Seller must complete sections 1 & 3) The purchaser's signature in section 3 is optional.
`✓ Bill of Sale (Seller and purchaser must complete sections 1 2 (when applicable) & 3).
1. Motor Vehicle, Mobile Home, Off- Highway or Vessel Description
Year Make/Manufacturer Body Type Model Color
2010 Ford Crown Vi Crown Vi
Certificate of Title Number Vehicle/Vessel Identification Number
2FABP7BV3AX114797
I /we do hereby sell or have sold and delivered the above described motor vehicle, mobile home,
off- highway vehicle or vessel to:
Print Name(s) of Purchaser(s)
Cape Auto Connect
Address City State Zip Code
1232 Viscaya Parkway Cape Coral FL 33990
Date of Sale Selling price 2,392.50
2/17/16 $
2. Odometer Disclosure Statement (Required For a Motor Vehicle)
Federal and State law requires that you state the mileage in connection with the transfer of ownership. Failure to
complete or providing a false statement may result in fines and /or imprisonment.
WE STATE THAT THIS MOTOR VEHICLE'S ✓ 5 DIGIT OR i 6 DIGIT ODOMETER NOW READS E] F21 El, El El F • xx
(NO TENTHS) MILES, DATE READ 2 / 16 / 16 AND WE HEREBY CERTIFY THAT TO THE BEST OF OUR KNOWLEDGE
THE ODOMETER READING:
f ✓ 1. REFLECTS THE ACTUAL MILEAGE. 2. IS IN EXCESS OF ITS MECHANICAL LIMITS. 3. IS NOT THE ACTUAL MILEAGE.
Affidavit (When applicable):
3 Certification
UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS
STATED IN IT ARE TRUE.
Seller's Signature Seller's Printed Name Date
Cw1�.U�Q/YY Lori McWilliams (for the Village of Tequesta) 2/18/16
Seller's Address City State Zip Code
345 Tequesta Drive Tequesta FL 33469
Co Seller's Signature (when applicable) Co Seller's Printed Name (when applicable) Date
Cape Auto Connect 2/18/16
Co- Seller's Address (when applicable) City State Zip Code
rchaser's Signature Purchasers Printed Name Date
Cape Auto Connect 2/18/16
Co Purchasers Signature (when applicable) Co Purchasers Printed name (when applicable) Date
OWNERSHIP STATUS FOR THE ABOVE DESCRIBED MOTOR VEHICLE, MOBILE HOME, OFF - HIGHWAY VEHICLE OR VESSEL
WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
Check your local phone book government pages or visit the following website for current mailing
addresses: http: / /www.flhsmv.gov /offices/
HSMV 82050 (Rev. 06/11) S
A04613
Mail Lien Satisfaction to: Dept of Highway Safety and Motor Vehicles, Neil Kirkman Building, Tallahassee, FL 32399 -0500
Identification Number Year Make Body WT -L -BHP Vessel Regis. No. T Title Number
F2FABP7BV3AX114797 �2010�FORD� 4D 4005 1 103557001
Registered Owner: Date of Issue 12/22/2009
Lien Release
VILLAGE OF TEQUESTA Interest in the described vehicle is hereby released
345 TEQUESTA DR ey
TEQUESTA FL 33469 Title
Date ►
IMPORTANT INFORMATION
1. When ownership of the vehicle described herein is
transferred, the seller MUST complete in full the
Transfer of Title by Sellersection at the bottom of
Mail To: the certificate of title.
2. Upon sale of this vehicle, the seller must complete
VILLAGE OF TEQUESTA the notice of sale on the reverse side of this form.
345 TEQUESTA DR 3. Remove your license plate from the vehicle.
TEQUESTA FL 33469 -3062 4. See the web address below for more information and
the appropriate forms required for the purchaser to 0
title and register the vehicle, mobile home or vessel:
�rr��rrr��ri�tt�r��rt�t�ttrt��r��rrrt��fftr�r�r�tt�t�f�rt�r�r� http: / /www.hsmv .state.fl.us /html /titlinf.html
Irlentficahon Number Year Make Body W> BHP, Vessel R'egls No Titld Number
Lien Release
2FABF76V3AX t 14797 2010 1 40 4005 103557001 Interest in the desenbed vehicle is hereby released
/ Prev Color Primary Brand Second ry Brand �lo o Use Prev Issue Date g T . � SN1eBLK an s RIVATE I Title /
F, Odometer Status or Vessel Manufacturer or OH use Hult Mdterial Prop Date of Issue,
Date
4 MILES 12/15/2009 ACTUAL T T12/22/2009
`EZegisLered Ovvner
VILLAGE OF TEQUESTA
345 TEQUESTA DR
TEQUESTA FL 33469
I st Lienholder
® NONE
0
i®
� -iUli
DIVISION OF MOTOR VEHICLES TALLAHASSEE FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
Control Number 0 6 8- 0 6 3 4
B
Cad A. Ford Julie L. Janes i
Director Executive Director
i
TRANSFER OF TITLE BY SELLER (This section must be completed at the time of sale.)
Federal: and /or slate law require selling price and d;de sold in connection with the iransferof ownership.
Failure to cotiiplete or providing n fitlse, tiny result in Sues and/or ittq)risonttieni.
This rifle is wom.mted to be fiee froto ony liens except as noted on the face of the cerlific;de mid the motor vehicle or vessel described is hereby hzwsfetred lo:
Seller Most Enter Purchmm's Nome: Address• ,.,
.gyp- �� n__^^ _- — ___
ScllerMnsl6'nlerScllingPric.• _ «i �Q� SellerMnslF.nlu'IlaleSOld ___
I /We stale dial Ibis l? 5 or F digil odometer now reads:I-t I _II5 , I S I I -5II_I. _X I (,to lcnlbn) miles, dale read �_� -l�_ and l hereby cedify dial. to the best ofttty knowledge dieodonteler reading:
reflects A(:, 'UAL MILEAGE. F-1 2. is IN EXCESS OF rl :y MECHANICAL LIMITS. 3. is NOTTHE ACTl1AI. MILEAGE.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I;HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
SELLER Mt l '
CO-SELLER FR Most
Sign Heta - .�_- I ivy _ Sign Here:
Print He-:�rt t - � 1Z tilL�Q�t13�_Vt, tlA�:t.G(!t Prinl:Hcte
!Wling Deader', Liccns.Namberr : __ _ "rsuc No _- -__ __ Tax Collected:
...... 'Aaefion Nrdne _ .. - .:. ' License Ntutthet -
.PURCL1f1 )�R Mus4 co RURCHASF..R Must
. Sigit Hcrci _ Sigh, Hcre
Pit t HerC Print Het.
..
Tics, AENALTY 1$ Rt UIR6[I 6Y LAttV:IF, N07 SVPMtTTED FOR -, rftANSFER 1tyITHIN 3D DAYS AFTER: DATE OFPURCHASE ><
item
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTOR VEHICLES
Neil Kirkman Building - Tallahassee, FL 32399 -0620
Notice of Sale of Motor Vehicle, Mobile Home or Vessel
Section 319.22(2), Florida Statutes, provides that by tiling this forin, you can avoid any civil liability for the operation of the sold motor vehicle, vessel or mobile home.
In addition to filing this form, we suggest you keep a copy of your bill of sale (we suggest it be notarized), certificate of title or other type of transaction document showing
the vehicle was gold. Complete the information below, tear the top portion of this document at the perforation and mail to the address above or submit to your
local tax collector's office or license plate agency.
I have this day of rv`3(toil _ , Cpl t, , transferred by assignment of and delivered Florida Certificate of Title to: ��11
Name: Purchaser(s) C Q y(.1 L C2Nne -+ Address I�SL&4a 1 plkuy Selling Price $ o(, 3 5o
1 �vrai FL 3349° T
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE V READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Seller's Signature - I' 1 , IU 1 0A Wjj CI &W- Co- Seller's Signature
NOTE: THE SUBMISSION OF THIS FORM, ACCURATELY COMPLETED, TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY OR TO THE
ADDRESS ABOVE WILL ALLOW THE TITLE CLERK TO UPDATE THE DMV DATABASE TO REFLECT THE TITLE RECORD AS "SOLD ". HOWEVER,
THE OWNERSHIP STATUS WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
QI�ITFY ERTIpICA'(ION - feetAf -as slatd iaty r� (utre tl at you sta g tlto )tulcagg lgortr cbupn wttii i ansfSt of o ynorghvP t uil relo cGuiPle't or ptocadgig rGfolsp sfgt?et 1ttt y >ts' Ytp fit€gSadtr93apfFrgrotDq� jt t
�CetpjigDeider s < Selling Dealers Tax , �dx
d leense 1Vn, home YU t o)Iested
�.. Selling Deaier?s Address,_ _ i6Datp 9atd ,�,
n . �ui'cRaser`s Names) - �,_ Address
I/WE:STATE T14AT THIS ❑ 5 OR 6 DIOI/T ODOMETER NOW READS " xX (NO TENTHS) MILES IIA7'E "READ 1 > AND I HEREBY
v.
CERTIFY THAJ' TO THE . BESTbfMY "OWLLDGETHEODOMETER:READI(1Cs: '
m CAUTION: READ CAREFULLY : El 1. ACTUAL MIL EAGE _!� 2. IS IN EXCESS OF ITS MECHANICAL „. LIMITS _:�❑ � �IS:NOT THE:ACTUALiMILEAGE.
:BEFORE YOU (EXCESS OF ITS MECHANICAL LIMITS WARNING - ODOMETER DISCREPANCY
w CHECKABOX APPLIES TO5 DIGIT ODGYETERS)
Purchaser Must Co- Purchaser Must ”
ti Sign Here : - _ _ - Sign Here:
m
94 Print Here: < Print Here:
:;. -. Seller/Agent Must Auction Name (when Applicable):
_ Sign Here:
' 'Print Here: Auction License Number:
'Selling Dealer's _ Selling Dealer's' Tax Tax
License No.: Name: _ Nos : Collected:
w Selling Dealer's Address: _ _ Date Sold:
A : Purchaser's Name(s): _ _ _ Address:
w 1 /WE STATE THAT THIS F 5 OR ❑ 6 DIGIT ODOMETER NOW READS , j
F . (NO TENTHS) MILES, DATE READ _ / _ i AND I HEREBY
L) CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE ODOMETER �EADINO: -:
m CAUTION: READ CAREFULLY ❑ 1. REFLECTS ACTUAL MIEEAGE 2. IS IN EXCESS OF ITS MECHANICAL LIMITS ❑ 3. IS NOT THE ACTUAL MILEAGE.
- BEFORE YOU ](EXCESS OF ITS MECHANICAL LIMITS WARNING. - ODOMETER DISCREPANCY
- CHECKA BOX - ;APPLIES. TO 5 DIGIT ODOMETERS) -
v < Purchaser Must - Co- Purchaser Must - -
ti Sign Here: Sign Here:
Print Here: - Print Herr
O ;
.Seller /Agent Must Auction Name (when Applicable):
Sign Here:
Print Here: Auction License Number:
Selling Dealer's Selling Dealer's Tax :Tax
License Nos; Name: No.; - Collected: -{
Selling Dealer's Address: Date Sold:
,Q Purchaser'sName(s): _ Address: -
2 VWE STATE THATTHIS E] 5 OR b DIGIT ODOMETER NOW READS XX {NO TENTHS) MILES, DATE READ / I , AND I HEREBY
a
_ CERTIFY THAT TO THE.13EST OF MY KNOWLEDGE THE ODOMETER READING.
m CAUTION: READ CAREFULLY L REFLECTS ACTUAL MILEAGE Z. IS IN EXCESS OF ITS MECHANICAL LIMITS 3. LS NOT TH&ACTUAL_MILEAGE. -
t-
BEFORE YOU (EXCESS OF' ITS MECHANICAL LIMITS ,.,.. 1VARNiNG- ,ODOMETER;DTSCREPANCY -:
Z t i . APPLiiST05.DIGITO:DOMETERS).: - -
PurehaserMust. i -Co • Purchaser Must
y. :Sign Hae - ::Sign Here
�a
Prtni Here Pant Here
$after /�Xgent lviust M. At Namg:(ti'hen Applicable)
tot TAactton'LtccPSe Warn er"