PLEASE NOTE THAT THIS IS A TWO-PAGE DOCUMENT INCLUDING ...
I certify that I am the owner of the vehicle described below and that: (1) I purchased the vehicle from the titled owner and I never titled the vehicle in my own name; or (2) I was issued a title in my name but the title was lost or stolen. I certify that the vehicle is worth $1250 or less and is at least eight model years old. ................
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