Casual Automobile Non Dealer Purchase Agreement

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Casual Automobile (Non-Dealer) Purchase Agreement
and Seller Proof-of-Ownership Information
SELLER 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 reading
as of (date)
_______________________
______________________
______________
This item is presently titled in the State of
Title #
Date
Seller Check One:
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
Address
#________________________
_______________________________________________
Loan Account
City/State/Zip
(____________)____________________________________
Telephone
_______________________________________
_______________________________________
_________________
Signature of Seller(s)
Date
VEHICLE DESCRIPTION:
Auto
Truck
RV
Other
OPTIONS:
(please check)
__Anti Lock Brakes
__Tilt
__4W Drive
___________________________________________
Year ______________ Make
__Power Steering
__Cruise
__Manual
__Power Door Locks
__Air
__Automatic
_________________________________________________
Model/Type (LX,EX)
__Power Windows
__Leather Seats
__2-Door
__Power Driver Seat
__Moon Roof
__4-Door
__________________________________
__Cassette
__Sliding Sunroof
Selling Price $_________________VIN #
__CD Player
__Custom Wheels
PURCHASER INFORMATION:
______________________________________________
Account Number
__________________________________________/_____________________________________________
Purchaser’s Name(s)
_______________________________________________
_________________________________________
Address
City/State/Zip
(_____________)________________________
(_____________)________________________
Home Telephone
Work Telephone
_____________________________________/______________________________________
Name(s) in which vehicle will be titled:
____________________________________
$____________________________
State where vehicle will be titled:
Amount Financed
_______________________________________
_______________________________________
_________________
Signature of Purchaser(s)
Date
AUTO INSURANCE INFORMATION:
_______________________________________________
________________________________
Insurance Company
Policy #
_____________________________________________
(____________)________________________
Agent’s Name
Telephone
Tides (klm Loans\CAPA.P65) Rev 1/10/02

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