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t _�� ��. _ _ - - � <br /> I����������� !� ND DEPT.OF TRANSPORTATION '� <br /> CERTIFICAT� OF TITLE FOR A VEHICLE \-�� 1�,ipTOR VEHICLE DN{SION ' <br /> NORTH DAiCOTA D�PARTMENT OF°TRA�ISPORTATION� 608 E BOULfVARD AVE ' <br /> ,iFN 2875(Rev.11-2019) BISMARCK ND 58505-0780 <br /> � TAlephone:(TU1y 328-27�5 <br /> YEAR YF.i�R ��� <br /> VMI MODEL RECiISTERED MAKE 80DY SME 3626ACK <br /> MY11200566K 2011 2011 HOUSE OF HARMQN f <br /> OWNERjS�NAME TITLE NUMBER VEHICLE 7YPE SHIPPING VYEIGHT DATE ISSUED <br /> ` ANCO�ax LLc, ND590078976 TRAILER 0 5/12/2020 <br /> OOOMETER REAOING ODOMETER STATUS <br /> EXEMPT � <br /> ., <br /> � �, <br /> � MAIL ANCOCAitD LLC � <br /> , To: P0 B0� 11222 <br /> WIUISTON ND 58803-004Q <br /> � <br /> � <br /> � <br /> a <br /> .a <br /> � THIS IS A DUPLICATE CERTIFICATE AND MAY BE � <br /> � SUB]ECT TQ THE RIGHTS OF A PERSON UNDER � <br /> THE ORIGINAL CERTIFICATE ` <br /> � �% <br /> `PART 1. ASSlGNMENT AND WARRANTY OF TITLE(DEl1YER TI7LE TO BUYER WITHIN 15 DAYS FROM DATE OF SALE) �� <br /> � Drivers License FEIN Telephone Number ��' <br /> Applicant's/Buyer's Legal NBme(first,mid6le,fast)or Firm tJame(Lessor,Trust): ❑ ❑ ��^ <br /> � Mailing Address City State ZIP Cade County ['� <br /> I� <br /> !� <br /> Co-ApplicanYs/8uye�s Legal Name(fl�st,middle,last)or Firm Name(Lessee,Trust): ❑flriver's License . "FEIN Telephone Number �� <br /> � <br /> ' Mai ling A d dress C i t y I S t a t e ZIP Code County � <br /> � <br /> � Check One: �Purchase Date(Mo.,�ay.Year) Purchase Price � <br /> []Or �And �And/Joint�enants with Right of Survivorship <br /> '' Odometer Disclosure:Federal and State laws requlre thaf you state the mleage in conned'eon with the transfer of owner5hi�. 'Odometer Reading � � <br /> ; {Failure to c�mplete o�prouiding a false sfafement may re5ult in fines andlor irt)PnsohmeM. n„rHs ' <br /> ��i certi(y to the besl of my knowledge ihe adomete�reading is the aclual mileage of the vehicle unless one cf the following e� <br /> statements is chedced ' '�eage stated is in excess of its mechanical limits. Odometer rieading is not the actual mileage(wamin9'odometer dfscr�pancy), .� <br /> � Si tu of el � or Dai�(Mo, y.Ye�r) Signature of ApplicanUBuyeNTransferee Date(Mo.,Day,Year) ' <br /> ��,�G�`: �-C.�t✓'�--t... S I���� , <br /> � Signature of 5e11er/TransFeror Date(Mo.,Day,Year) Signature of Applicantl8ugerfTranste�e Date(Mo,Day.Year) � <br /> � <br /> � Hand-Pririted Name(s)ofi Seller(sy°rransferor(s) Daytime Telephone No. Hand-Printed Name(s)of Applicant(s�8wye�(sN'frsnsfefee(s) � <br /> a <br /> LEGAL TITLE OWNER(LIENHOL.DER) 1 czrtNy tt�at the aPplicanl ttas tomplietl with the requiremei�tis ot Title 39 of the North � <br /> ii <br /> My lien recorded in ihe at6c�uf the Daparlment of Trensportatbn Is shawn beto�v-The b8kata Century Coee relaNve to the issnar�Ee oi a cerl'�tCete of title Tor a vehicle. <br /> lien holder name4ls anp stiail remain k+gal owner of the vehiGe until the encumbrance is <br /> �� released or satisfied. � <br /> � <br /> � <br /> p u1y Director er Safety � <br /> L1EN�RELEASE-ALL INTEHESTS IN THE VEH►CLE DESCR�BED ABOVE ARE BELEABED. � <br /> ~ � Lienfiolder Name � <br /> Signature of Agent Date(Mo.,oay,Year) ; <br /> . <br /> � <br /> THE DEPARTMENT OF TRANSPORTATION IS NOT RESPONSIBLE FOR <br /> , 4 FALSE OR FRAUDUIENT STATE�IAENTS MADE IN 7HE ASSIGNMENT OF : <br /> j-' �� > �_? _� .� ` THE CERTIFICAI'E OF TITLE. s�2e�s��t-zb�9� i <br /> , .. <br /> �+'.1' -�'- � }q �,,1� �1 � � • • " _� � _, <br /> .,: ..6������ _ . _ - _ . � <br />