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5.1A Completed Applications
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10-15-2020 Planning & Zoning Commission Meeting
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5.1A Completed Applications
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10/9/2020 9:26:59 AM
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.f [- ^�•. - �' _ - ' � � � <br /> CERT�ICATE OF TITLE FOR A VEHI.C�E ���r'�r�w��� �j� ND DEPT.OF TRANSPORTATION <br /> � MOTOR VEHICLE DIVISION <br /> . NORTH DAKOTi4 DEPARTMENT OF`TKANSPORTATION� 608 E BOULfVARD AVE <br /> SFN 2875(Rev.11-2019) BISMARCK ND 58505-0780 <br /> T�lephone:(T01)328-2725 <br /> YEAtt YEi►R ��� <br /> VIN MODEL RE�iIST�RED MAKE BODY SME 3B�� <br /> MY11200566K 2011 2011 HOUSE OF HARMQN <br /> OWNER�S�NAME TfTLE NUMBER VEHiC4E TYPE SHIPPING WEIGHT DATE ISSUED ` <br /> ` ANCOCA uc, ND590078976 TRA'ILER 0 5/12/2020 <br /> ODOMETER REAOING ODOME7ER STATi1S � <br /> EXEMPT � <br /> , <br /> ' � <br /> � MAIL ANCOCAitD LLC E <br /> , T�: PO B0� 11222 <br /> WILLISTON ND 58803-004Q <br /> � <br /> � <br /> � <br /> � <br /> -� <br /> fi THIS IS A DUPLICATE CERTIFICATE AND MAY BE � <br /> � SUB�ECT TO THE RIGHTS OF A PERSON UNDER � <br /> . THE ORIGINAL CERTIFICATE ` <br /> � �% <br /> `PART 1. ASSIGNMENT AND WARRANTY OF TITLE(DEUYER TI'RE 70 BUYER WITHIN 15 DAYS FROM DATE OF SALE) �� <br /> Driver's License FEIN Telephane Number ��,�, <br /> � ApplicanYs/Buyers Legai Name(first,middle,fast)or Firm Name(Lessor,Trusf): ❑ ❑ f� <br /> t-, <br /> Mailing Address City State ZIP Code County �� <br /> Oriver's License [)FE�N Telephone Number �' <br /> Co-ApplicanYs/8uye�s Legal Name(first,middle,last)or Frm Name(Lessee,Trust): �� <br /> hl�� <br /> ' Mailing Address City I State ZIP Cade County �3�, <br /> A <br /> �� Gheck Q�e: Purchase Date(Mo.,�ay,vear) Purchase Price ,� <br /> �Or �And �And/Joint'�enants with Right of Survivorship <br /> y' Odaneier Disclosure:Federal and State laws requlre tha4y�nu state the r�liteage in eonneclian with the lransfer of ownersfiip: 'Odom� eter Reading � �l <br /> ; {Failure to complete or providing a ialse stalement may result tn fines and/or iR�Prisonsneni. ,�,vrHs _` <br /> �I certify to the best oi my knowledge it�e adometer reading is the ectual mileage of the vehicle unless one of the following <br /> statements is checked: '(eage stated is in excess of its mechanicai limits. Odometer t�ading is not the acival miteage(wami►ig`odometer disc�pancy); .,. <br /> �� Si tu of eller � or Det�jMo, y.Y�r) Signature of Applicant/BuyeNTransferee Date(Mo.,Day,Year) �' <br /> �� �-l.�t✓'�--� d I d�� <br /> Signature of SellerRransferor Date(nno.,Day.Year) Signature of AppllbanU8oY8rlTransferee Date(Mo,oay.vear) 3 <br /> n -PridCed Nam s of Sdfer s ° ransferor(s} Daytime Telephane No. Hand-Pfirrted Name(s)of Applicant(sjl�wyet(s�tTrensfe�ee{s) � <br /> � Ha d e( ) ( YT �� � � <br /> LEGAL TITl..E OWNER(LiENHOLDER) 1 r,2rt�y t�+at the applicant ttas comptieci with the�uiremeMs ot Title 39 of Ihe Narth � <br /> My lien recorded in i!�btfic�uf the pepaAment of Transporlation Is shown beb�v,7he b9kot2 Century Cooe relativa to thE�ssnante of a cert'dls�te of tiNe Tor a vehicle. <br /> lien holder named Is'and shal�remain Iega)owner of the veh'iWe untll the encumbrance is <br /> released or satisfred. <br /> � <br /> j � <br /> � - � <br /> b uiy I?irector er Safety � <br /> . j L1EN AELEASE-ALL tNTERESTS IN THE VEMCLE DESCR�BED ABOVE ARE HELEASED. � <br /> � Lienholder Name � <br /> r Signature of Agent Date(Mo.,Day,Year) �; <br /> �: � <br /> THE DEPARTMENT OF TRANSPORTATION IS NOT RESP�NSIBLE FOR <br /> FAL3E OR FRAUDU�ENT STAT�IAEWTS MAOE IN THE ASSIGNMENT OF : <br /> .-• �< -� �.� �' •` 7'FiE CERTIflCATE OF TITLE. s�ze�s Irt-2o�9� - <br /> � � � 3 <br /> I :J . �_:_. _. <br /> �'-+�ti�e����.rA,..-a,'�..d�..:l;1=?'�%�:�;��" � ' � " " :.�� . . ' -. <br />
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