Form 4606 - Bill of Transfer (Farm Products Only)

Form

4606

Bill of Transfer (Farm Products Only)

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"I,______________________________________________________________________________________________________ ,

(Transferor's Name)

transfer to_______________________________________________________________________________________________

(Dealership's Name)

the farm product(s) listed below as a trade-in towards the purchase of a motor vehicle, trailer, or all-terrain vehicle purchased for agricultural use."

Agricultural use - Used in cultivating or raising agricultural products.

Produced or raised - means the transferor of the agricultural product either cultivated the grain or has cared for the livestock.

Product (Type Of Grain, Livestock, Etc.)

Quantity (Pounds, Number, Etc.)

Trade-In Value

Agricultural Product Information

The farm product (Please select and complete one of the following):

r Was physically delivered to the Dealership on __ __/ ____ /__ __ __ __ by _____________________________________ r Is being stored at a grain elevator or stockyard. r Farm product location:______________________________________________________________________________

________________________________________________________________________________________________

Note: If the product is being stored at a grain elevator or stockyard, a separate receipt issued by the grain company or stockyard must be attached to this bill of transfer. The receipt must show that the dealership has legal title to such farm product. A statement or invoice from a grain company or stockyard in the name of "cash sale" is not acceptable. A check made payable directly to the dealership by the grain company or stockyard is not acceptable without the receipt from the grain company or stockyard showing the product was transferred to the dealership.

Newly acquired motor vehicle, trailer, or all-terrain vehicle information

Year

Make

Identification Number

Vehicle Information

I certify under penalty of perjury that I have produced or raised the farm product(s) referenced above and traded it to the dealership indicated. I further certify that the newly acquired vehicle referenced above will be used for agricultural purposes.

Signature of Transferor

Printed Name of Transferor

Required Signatures

I certify under penalty of perjury that Ihave accepted legal ownership of the farm product(s) listed above as a trade-in for the above listed vehicle for the value shown.

Signature of Authorized Agent for Dealership

Printed Name of Authorized Agent

This form must be attached to your motor vehicle title application.

Motor Vehicle Bureau P.O. Box 100 Jefferson City, MO 65101-0100

Phone: (573) 526-3669

Visit for additional information.

Form 4606 (Revised 04-2014)

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