E:\Loans\CAPA.p65
Casual Automobile (Non-Dealer) Purchase Agreement and Seller Proof-of-Ownership InformationSELLER INFORMATION: The seller agrees to sell vehicle to buyer according to the facts stated herein.Seller’s Name(s)/Address City/State/Zip Home Telephone ( )Work Telephone ( )TITLE AND LIEN INFORMATION: Odometer readingas of (date) This item is presently titled in the State of Seller Check One:Title # Date ? I hereby swear the vehicle being sold has NO liens or encumbrances.? There is presently a lien on the above with:Financial Institution Payoff amount of $ Loan Account # ? Address City/State/Zip Telephone ( )? Signature of Seller(s)DateVEHICLE DESCRIPTION:? Auto ? Truck ? RV ? OtherOPTIONS: (please check) Anti Lock BrakesTiltYearMakePower SteeringCruise Power Door Locks Air 4W Drive Manual AutomaticModel/Type (LX,EX)Power WindowsLeather Seats2-Door Power Driver SeatMoon Roof4-DoorSelling Price $ VIN # Cassette Sliding Sunroof CD PlayerCustom WheelsPURCHASER INFORMATION:Account Number Purchaser’s Name(s) / Address City/State/Zip Home Telephone ( )Name(s) in which vehicle will be titled:Work Telephone ( )/State where vehicle will be titled: Amount Financed $ ? ? Signature of Purchaser(s)DateAUTO INSURANCE INFORMATION: Insurance Company Policy # Agent’s Name Telephone ( )Tides (klm Loans\CAPA.P65) Rev 1/10/02 ................
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