HomeMy WebLinkAbout2000 Ford Expedition MINNESOTA MOTOR VEHICLE REGISTRATION CARD RECORDED OWNERS)RECORD OF SALE
TAx
NUMU' PLATEER =----,NUMBER F122 0M9510 r NUM ER i �{ �L `.'
/ EXPIRE TPLATES / \. BASE 331 5 NUMBER F 7 0
/` MAKE MOOELV AR �I TYPE
vLN Ft1R0 OD! ''r 4W EPT vIN 1 �Lti , ,/ , 6653
� IFM'PUIb ' YL83' {�53 N MBER EEXCISE TAX XCUPE FEES I
7, J
1 CITY 0AK PA HTS
4 E - � gyp ` BuvERssIDMATu - / SALE DATe
fl 14168 N 57TH T p4)±..., 07 /
E STILL3i4TER MN� 55082-6409 STREE ADDRESS
( Om' STATE ZIP CODE
'"� f o, (DETACH THIS PO RTION�' !/ y '",T. N '' f'09
NOT SEPARATE UNTIL SOLO' w",
,� CERTIFICATEyOF-TITLE,� -i Y
'''')� TO A MOTOR VEHICLE `tS �, ;
, 1 THIS TITLE IS PRIMA FACIE PROOF OF OWNERSHIP \
(I�/0.[';'•'"..,:• '''' l KEEP IN A SAFE PACE' ANY ALTERATION OR ERASURE VOIDS THIS TITLE � � y�
,
1FMPU16LXYL836653 N/REDO FORD 00 4W €P:T
VEHICLE IDENTIFICATION NUMBER ODOMETER AK€ YEAR TYPE
k F122OM95O 05/01/00 NEST 00
TITLENUMBER DATEISSUED NEWORUSED IFNEW'DATE OFFIRST SALE FOR CENTRALOFFICE USE ONLV—
NO SECURITY INTERESTS OWNER 00B 000°0 ,;;
GI TY OAC PK fiT;S
14168 N 57TH ST PO 2007
STILLWATER MN 55082-6409
3316
A NMBN[BYsE4+EIIrtRANSf RDA• I'" ' '
FEDERAL AND 4.
MINNESOTA W E)D,la.THAT YOU STATErTH- ILEAGE iN CONNECTIfN4 WITH THE TRANS R.OPOWB) ))THIPW REQUIRES THAT YOU
MAKE DISCLOSURES ABOUT t IgONTROL,i;,C?UIPM /AN(S'bAMAGE TO THE VEHICLE.FAILURE TO CSN',..,,,,
R ROVnD„M.A E STATEMENT MAY RESULT
IN FINES AND/OR IMPRISONME &,DIMS EXEMPt10NS MAY 'EY.;
ODOMETER DISCL RE STA ENT I(WE).STATE'RIAT ODOMETER NOW DAMAGE DISCLOSUR STA'1FI.`f)'NT TO/S ESTOF MY KNOWLEDGE TRIS.
f',#
0 " �'(NOTENTALAELEE ND TO THE BEST EEHICLE ❑; I �i (CHIxiC ONE)SUSTAINED DMrMQE IN
r OP NY:I NOWLEDGE THAT it R FLECTST}IE ACYUA$1d1LEA OF THE VEHIOLE EXCESS OF 70%ACTUAL
DESCRIBED HEREINUNLESS OIjEOFTHEF,Q.LOWINQSTATEM=7S IS CHECKED. I
POLLUTION SYSTJcM D 'OBV TATEMEHT.TO THE BEST OF MY KNOWLEDGE
['� 11) I HEREBY CERTIFY T THE$E$TOF MY KNOW%,EOEI E ODOMETER THE POLLUTION. $y ON THIS VEHICLE INCLVDING THERESToveo
READINQ REFLEGTEtTHS AMOUfiT OF MILEAGE IN CESS OF ITS
a = MECHANICM UNITS. 1✓' GASOLINE PIPE /l.[j+,tUS HAS NOT(CHECK ONE)BEEN REMOVED,
1! ALTERED OR FRED EPERATIYE.
F�\ [] (O- I HEREBY CERTIFY TH(1TTHE ODOM�ET'ER FiEA�111N(i IS N(}T CNA(.
MLFAGE. T
WARNING-ODOMETEFF DFSCRE NtL‘Y IF BGYX(i)OR{2)'IS CHECKED, ASSIG ME T.I(WE)CERTIFY TH THIS VEHICLE tS FREE FROM ALL SECURITY
1A INTERESTS,WARRANTTITLE ANDA ION THE VEHICLE-AND REGISTRATION PAID TO:
iT`f bFr.44-Y A tiGHTS .
{ SELLERS PRINTED NA�M9E�� DATE BUYER'S PRINTED NAME
BELLE'.. �-MIDRESS „' BUYER'SADDRES.,
BEUd}N!,'SIGNATURE BUYER'S SIGNATI4E
CO'PLETE REVERSE SIDE - ' APPLICATION FOR TITLE BY EUYER{TRANSFEE) '..
,. PAINT BUYER'S FSR/.NAME(S)LAQT-RRST.I{D'#�IIDDtE DATE(S)OPSlyTN
S7REETADDAE39 CRY CXX11fiY � STATif ZIPtTODE
` IS THIS VEHICLE SUBJFCTTO SECUhffY AGRE II5$T(S)1 NO 0 YES Q .ADDITfONAt>,- 5.. YES,COMPLEFE SEQIJON BELOW ''�
AllEY SECURED PARTY(PRIM!NAME) OF SECURITY AGRBEMENT
�r
S7REET�'ADDRESS CRY S#!A ZIP CODE
Istesnele ANADIZIONAL NAMEOF POLICY
SECAET'YAWTEEMRNT(B); INSURANCE NUMBER
COMPLEI AEIREETTACHUPSPetZ. COMPANY
T(We).SeRBy I(we)am(are)v1 IEgNI age,flava bought 8113 vehicle subject to Ilene shown and no others,this vehicle N ander It CS,1SRMe TD be Insured whge.operaIIng Upon!ha
.�^�, PUbIIC eBeWs and h)gbways,and ell of my(our)dedarationa SIR file and COrrRct. \.
(AWORTANT•PLEASE REAS:PERSONAL MFORMATION CONTAINED IN YOUR MOTOR VEHICLE RECORD MAYBE DISCLOSED TO ANY PERSON WHO MANES A IRW3ST FDR IT THIS PERSONAL INFQRMATIQN
,f MAYAl3OSEi1SED,REMEDOPQMT:ORUSElNQTAATHREEDTINAANDSC{,KYTATBI5ELSEMVIICTTHESEUSAOES RVEYS'MARKIHEAORSCL M7EBOXtB)BELOW'
bONQ7O16CL0$EMY KIFORMATWNTOANYbNE NO7 AtITl1oRIZED OY TAW,d..DONOTDISCLOSEMYINFORMATION FOR SURVEYS;MARICETIN0 fM 9DLfCrfATKKJ3.:❑
4' i.A VEHICLE PLATE NUMBER YEAR FOR VALIDATID ANDP E USE ONLY•
I
UBLIC SAFETY CI 1...--�
Di
,ervices Division
MN 55101-5160 YEAR VALIDATION STICKER NUMBER YEAR ��,
ICE USE ONLY --) APR 2 7 2004
_ { I
WEIGHT STICKER NUMBER/MOTORCYCLE ENGINE# D )Y ' 3 !' i3
NON-NEGOTIABLE REGISTRATION RECEIPT(CARD)AND CAB CARD
NEW ID PREY US LATE NUMBER YEAR MONTH YEAR THIS COPY WHEN VALIDATED,STAMPED ON THE UPPER RIGHT
EXPIRATION CORNER BY A DEPUTY REGISTRAR OR THE CENTRAL OFFICE,WILL
USED` V ( / t(. DATE -�( `% SERVE AS EVIDENCE OF THISTHE OWNER FOR USE ONLY ON THE VEHICECEIPTCLE DESCRIBED.S BEEN
TO
MAKE �O(-DYY/MODEL PE COLOR TRUCKS/TRAILERS
ff CODE DOT# EMPTY WEIGHT #OF AXLES
' Ia BODY ROOF
•
VEHICLE IDENTIFICATION NUMBER _ 0 You may disclose my personal information for any use In response
1 I Y/ \ ' ) f �, / to requests for my individual driver or motor vehicle records.
/ %%%) X i , (C 4�(/J/I l�V�f� 0 You may disclose my personal information for bulk distribution for
surveys,marketing,or solicitations.
DRIVER LICENSE NO.I DEALER NO. DATE OF BIRTH
M
•OWNER(S)LAST,FIRST, kalDDLE DRIVERS LICENSE NO. DATE OF BIRTH
U( X (tl''/l,U G I
/A -)Uu( CITY C�
AWW
V CaTYS1 �l 11 sr rtE 0zIP COJ V J,
•
>UBJECT TO SECURITY AGREEMENT(S)? YES I NO 4 IF YES,COMPLETE SECTION BELOW.
NT NAME) DATE OF LOAN FOR ADDITIONAL SECURED PARTIES,
imATTACH COMPLETED FORM NO.PS2017
PURCHASER(S) STREET ADDRESS CITY STATE ZIP CODE
OWNER(S)
MUST
COMPLETE
IIODOMETER DISCLOSURE STATEMENT.I(WE)CERTIFY THAT THE ODOMETER DAMAGE DISCLOSURE STATEMENT. TO THE BEST OF MY KNOWLEDGE THIS VEHICLE
NOW READS (NO TENTHS)MILES AND TO 0 HAS 0 HAS NOT(CHECK ONE)SUSTAINED DAMAGE IN EXCESS OF
THE BEST OF MY KNOWLEDGE THE ODOMETER MILEAGE IS: 70%ACTUAL CASH VALUE
SELLER(S) 0 ACTUAL MILEAGE POLLUTION SYSTEM DISCLOSURE STATEMENT. TO THE BEST OF MY KNOWLEDGE THE
POLLUTION CONTROL SYSTEM ON THIS VEHICLE INCLUDING THE RESTRICTED GASOLINE'
MUST 0 EXCEEDS MECHANICAL LIMITS OF ODOMETER PIPE
COMPLETE ❑NOT ACTUAL MILEAGE—WARNING ODOMETER DISCREPENCY 0 HAS 0 HAS NOT(CHECK ONE)BEEN REMOVED,ALTERED,OR RENDERED
AND INOPERATIVE.
SIGN ASSIGNMENT: I(WE)CERTIFY THAT THIS VEHICLE IS FREE FROM ALL SECURITY INTERESTS,WARRANT TITLE,AND ASSIGN THE REGISTRATION TAX
AND VEHICLE TO THE PERSON(S)NAMED ABOVE:
SELLER'S PRINTED NAME(S) DATE OF SALE
XSELLER'S ADDRESS DEALER LICENSE#
A
- ALL SELLER'S SIGNATURE(S)
PURCHASER'S MOTOR VEHICLE SALES TAX DECLARATION BASE VALUE OR REGISTRATION TAX+$ I V
D1.FULL PURCHASE PRICE $ GROSS WEIGHT: .4 , ,,_ PLATE FEE (C) ""`
REGISTRAT R�I/OD ARREARS TAX
PURCHASER(S) 2.LESS MTRADE-IN M NO.6 FROM 1 THROUGH ,)'U W CONVERSION FEE
OWNER(S) COMPLETE ITEM NO.6
MUST 3.NET PURCHASE PRICE CHANGE OF GROSS VEHICLE WEIGHT
COMPLETE TIME OF
AND a. %oF E3 CHANGE HOURS PUBLIC SAFETY VEHICLE FEE
SIGN 5.LESS TAX P D TO ANOTHER STATE $ DATE OF TRANSFER TAX
ET SALES TAX DUE CHANGE I I TITLE/TRANSFER FEE
6.T E-IN WAS MAKE PLATE NUMBER DATE - MOTOR VEHICLE SALES TAX
MODEL YEAR CHANGE
MN DEALER LICENSE# EXPIRES
I DECLARE I I LATE TRANSFER PENALTY
THIS TAX MN SALES TAX ACCOUNT# CHANGE OF WEIGHT AND/OR CLASS SUB-TOTAL $
EXEMPTION FROM TO I) �'
CODE: INTERNAL REVENUE CODE#(IRC) STATE/DEPUTY FILING FEE
I(WE)CERTIFY I(WE)ARE OF LEGAL AGE,HAVE BOUGHT THIS
PRORATE ACCOUNT# a VEHICLE SUBJECT TO LIENS SHOWN AND NO OTHER THIS VEHICLE I
(Sales 12X due When registered) IS AND WILL CONTINUE TO BE INSURED WHILE OPERATING UPON TOTAL DUE $
THE PUBLIC STREETS AND HIGHWAYS.THE VEHICLE WILL BE
OPERATED IN COMPLIANCE WITH THE LAWS WHICH APPLY TO ITS /
CLASS OF REGISTRATION, HAVE RECEIVED A COPY OF THIS
WITHOUT PROPER OWNERSHIP/TRANSFER APPLICATION AND ALL OF MY(OUR)DECLARATIONS ARE TRUE AND I '._f (� (l l
CORRECT (WE)HOVE KNOWLEDGE OF STATE AND FEDERAL rNV �
DOCUMENTS (e.g.,OUT-OF-STATE CERTIFICATE MINNESOTA STATUTES, CHAPTER 221, PUBLIC PSERVICE �� �J ' ` �
OF TITLE)NO MINNESOTA TITLE WILL BE ISSUED. COMMISSION RULES 1 THROUGH 48,AND CODE OF FEDERAL L�)
REGULATIONS, TITLE ZA PARTS 390 ACO 39O AND IF A
TRANSPORTER OF HAZARDOUS MATERIALS,CODE OF FEDERAL V
REGULATIONS,TITLE 49,PARTS 1171 TO 199. I ^
111111111II,11111 II1111I MI SIGNATURE(S)ALL PURCHASERS/OWNERS MUST SIGN DATE
L:H:NE:(651)297-2126 TDD/TTY (651)282-6555 WEB;mndriveinfo.org .PS2000-28 -
r r ' Au(omatedSe►f SenrioeL`(fi61)`2 1nM ,b0 NOT'SIGN,UN`fli.tOMAL Fi ;�'�'�'�
• <— r r r r 1 1 1 8 > r r i I I rot ! s ,4,°.' t t4 t
,.at f1.• t 91 f�l�1 f 1 __1�Y f 1 ' T ' ' I ' ) r i(,'.1.I.`.4t,' tit t4 414' - f ' I rJ J > I . Jr,oPr T�r,1,r Y I�a�I�F c :.<.1�f , r ! f , 1 . ii r 1 f.1,I.