HomeMy WebLinkAboutCertificate of TitleTO 517957012
B4 9071
----- (dentiScali Number T --- Year----Mdke---?-- Wadi ---- Body , NIf-L-BHP - i- --- - Vessel Regis. No. ---- �— Title Number — --1
�3700184 1972 =1H ! HS i 56' I 15170509 !
I RC�SItitCCCd 0-wrier Date OE TSSAe
LOLi3:SE PROVENCPJER 11/3-4/2007
3891 Sit 2 6TH S7f lWere,t in the above described v S
PEt+L'3ROK13 PAPSC, FL 33023 ticte i, hrry)7 re'.case;
BY
Mail To:
I&Lr.anmar.E idOTEL SNC
4895 SW 26 ST
PEMBROKE PARK, FL 33023.
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Date
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ldenbpG,`lio¢NUmgef'*�;- Year= Make ModelI3ody�
7001�4 a jalM tl 1972 NEF1Mz
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DIVISION Op ytOTQfj,VEH)GCE8 - TALLAHASSEE FLORIDA -
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• `TRANSFER OF TITLEBY SELLER (This5 secllon must be completed at the'time of sale.) 1 1' - •� +"• i:1t
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ODOYIEIFR CERT'IF7CSIlON-I'ial ral ,uul store 1. w rcquitc than wu Mutt the mileage in wnil ction with the Itaasrer of ownership. Failure to vnlplrlc or pnniding a fakir srrttmcui may: resuJl ut fines and/or [m7ntwmr aio I
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_ r 71us lith tf w.uerotcd and c rttticd lu lx Tree from a¢vbtn ex rJRs nM d qu tht f.•nl of thfa cendre t and tl nar nr r 1 41 or ts.1 dcantrd i, II • A Ieulsl rml lc
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:.t l s, d a read - ! d to Ih, hM c f toy Jm nt I dgt CAUTION: u 1. I her b xlb y that to tlt b> 't of my A t u Iedgr W odometer h di. «Ileac d +umnnn ur
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Bu:.uRM,XCrSTliE ACli(J.V. lLfi.\(.L of lh: yehicl�drstnlxd lu•r�ur,. DO\OI'CHf�K EXCL•SSOFr1:SNirci IANICr\LLI.NIIIS: -
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-OF PENALTES THE FOREGOING
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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 filing this form, you can avoid any civil liability for the operation of the sold motor vehicle, vessel or mobile home. in
9, add4ion 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
`veicle was sold. Completethe 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.
r51 have this day of , transferred by assignment of and delivered Florida Certificate of Title to:
r/ P Name: Purchaser(s) Address Selling Price $
= ,UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
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�•t. Seller's Signature Co -Seller's Signature '
f OTE: 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.
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d U ,OOOMLTER CERTIF1CA179N"- P."and smtcla%vsmquin.thatyrou,statc themilcngein mnnenion'.wilhtrans(er ofowperihtp,: ailurc to romDlGC:of pmsad'utgufalsc's[memeni may re.Wrin foes mtVori[uPltsbnmen{:°'
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Selling Dealer's Address: i Date Sold,
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Purelmser Name(s): Address:-
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'f/R'os[alc Natthis 5 Sdi lodome[ liiiw etlds4 '
Gt rr" (no tepths) m,tes Jatc nad J am�to the I cst mr Mowl dge that eh 'a t
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+} n'.. xI [ chicle ilesciihdh tty:u We one of the domerer smterceee blocis is
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CAUTION:_ DO NOT CHECK.. _'' El1. 1 hereby ccdifY IhaC to'[ he brit of my knos Irdw the odo ter modolg �. - Q-2 I he,chy cem(y [hat'Ihe odometer rcwh g fs nn[ Ihe'netml mdrnac. -
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BOXIFAL711%1- renecuthearea mofreilcaget [It mCcA�nicnl'1•mits - WARNING- ODOhIETER DISCREPANCY. - -
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MILEAGE (Emsy ,fits michonkW Rorke applies to n'digit odometms) � - -
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^Purchaser 4et I- lit , Y. „ ✓y' _
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chicle tkuriheA htyeiu,:unless arse a(Ihe adomruK statemcat blocks is checkrd.
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CAUTION: DO NOT CHECK ❑ 1. heerby mtify than to the best f niy le.-Idge 11-1 meter reading ❑ 2. 1. �
byamify that the afninerer reading l t eh t I' It
BOX IF A(TUAt, Dccu vt n nt C.ml g i lit h-ni It n r WARNING UDODIF+TER DISCREIANCY
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IMLEAGE _ (Excg. r 1. Yn Irmid, h Dy t pPl1 r 9 digit ndom Ivry) _ -
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Sign Here:
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Scirh%geat Masi .. <::' . ✓.n Aucl on Name. (Wh ADDI[rnhlr) - - -
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Pnn[ He r "fi a --Amnon Guns: Number. r #°' l
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Selling Dealer', .. ,� Settle Dale's 11u 1 i (Tax
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Uceose Na Name: 1
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selling Dealer" sAddress �•
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Date Sold
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1/Wc s ate that (his ❑ 5 or ❑ G digit dome er naiY £cads ,lstattad er. and 1 the bmt of rey knncldge that it Is1lecls31, act nl mdem of the
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FChiele desCnhe dhuein. anless one of the odo statcn ei rlent blocks ischsted
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CAUTION 'D() NOT CHECK t I hrcchp certify (hat to the best otmv koowl dgc Ih udannet rcadr g,. ,, �, ❑ 2 I h rl end Ilu[the admneter rc-.tdmy t rhonet '-
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BOa.IF ikCI'0AL �. '' Iltsli"Ihe mom[ tmIl ag In gs, ril echp[ytfalli.P,i4, t lVA \I.. •ODOyETER OLSCRdies - t ;
•` ( r M111I:F.f(.F..� r (Lyres rR meeban[thm muppbcr
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Sign Hero: Sign Hue: - - -_
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Sign Here: ...k
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Auclmn Lmense Number.