HomeMy WebLinkAbout13-4158 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: CERTIFICATE OF TITLE FOR
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PETITION FOR CERTIFICATE OF TITLE TO A MOTOR CLE
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The Petitioner(s) _:ady✓1A--_-, � - �66
reoest(sTl
that this Court approve the issuance of a Certificate of Title to Petitio;Vr(,,;fl for the
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motor vehicle described below, and in support thereof, represent(s) as follows:-'"1 "P
i. Pet itio rip er( ) is/are an adult individual(s), whose date of birth is
-7 and who presently reside(s) at
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2. Peitioner(s) is/are the owner(s) of the following motor vehicle:
a. Vehicle Description J 7&5- � W TXf,5
b. Vehicle Identification Number (VIN) S_05�- 791t
3. Title to this vehicle on the records of the Pennsylvania Bureau of Motor
Vehicles is registered to AJ JA whose
last know address is
4. There are no liens of encumbrances against the vehicle except
5. Petitioner(s) request(s) a Certificate of Title for the vehicle for the
following reasons: ?,e,5 ta-r4n 0r (0 S_ U Lki 6S
Resp tfully submitted by,
Petitioner(s)
JJ'_ SS
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Telephone No. 1'7- S_8-"0 - Z8-S_6
The above statements are true and correct to the best of my/our knowledge,
information and belief. I/We understand that false statements herein are made
: falsification subject to the penalties of 18 Pa.C.S. ?4904 rel g to unsworn falsification to
authorities.
P petit I
etitioner((s)
Vehicle Bill of Sale
For the Exact Sales Amount indicated below, I the Seller, do hereby sell and transfer ownership of the
Vehicle described below to the Buyer, acknowledge full receipt of payment, certify that I have the
authority to sell it, warrant the Vehicle to be free of any liens or encumbrances, and certify that all
information given is true and correct to the best of my knowledge.
Vehicle Information
VEHICLE IDENTIFICATION NUMBER(VIN#) ENGINE NUMBER(if applicable) LICENSE PLATE#
53V79 I I 41E! 452 S"Zo
YEAR MAKE MODEL BODY STYLE(2 Dr,4 Dr,etc)
1965 VW Bus 3 Dr
ODOMETER READING(Miles) SALE DATE EXACT SALES AMOUNT
8118/12 $ 1,000
(USD)
Conditions and Warranty
The Seller has no knowledge of any hidden defects in and to the Vehicle, and believes to the best of the
Sellers knowledge that the Vehicle is being sold in good operating condition "AS-IS,"meaning that there
is no warranty for any defects and that all repairs are the responsibility of the Buyer.
Seller allows the Buyer 0 days to have the Vehicle inspected by an independent mechanic, and agrees to
cancel the sale if the inspection is unsatisfactory to the Buyer.
Odometer Discloser Statement
Federal and state law requires the Seller of the Vehicle to state the odometer mileage upon the transfer of ownership.
Failure to complete or a false statement may result In fines and/or imprisonment.
I the Seller, hereby certify to the best of my knowledge that the ODOMETER READING listed under the
Vehicle information above was not altered, set back, or disconnected while in the Seller's possession, and
the Seller has no knowledge of anyone doing so, and is(check one of the following):
X THE ACTUAL MILEAGE
MILEAGE IN EXCESS OF MECHANICAL LIMITS
NOT THE ACTUAL MILEAGE. WARNINGI ODOMETER DISCREPANCY
S SIGNATURE SELLERS PRINTED NAME DATE
X-7 Shane Morgan 8118112
SELLER'S ARESS CITY STATE ZIP
5580 Elizabethtown Road Lawn PA 117041
BUY V4$IGNATU BUYERS PRINTED NAME DATE
Thomas J. Beene 18118112
BUYER'S ADDRESS CITY STATE ZIP
27 Fort Street Lemoyne PA 117043
Contact your state's motor vehicle department to find out if there are special requirements for the sale and transfer of your vehicle.
IN RE: CERTIFICATE OF IN THE COURT OF COMMON PLEAS OF
TITLE FOR THOMAS J. CUMBERLAND COUNTY, PENNSYLVANIA
BEENE,
VIN: 5087911 13-4158 CIVIL TERM
IN RE: PETITION FOR CERTIFICATE OF
TITLE TO A MOTOR VEHICLE
ORDER OF COURT
AND NOW, this 5th day of August, 2013, upon consideration of the Petition for
Certificate of Title to a Motor Vehicle, the Court hereby awards ownership of one 1965
VW Bus, bearing vehicle identification number 5087811 to Thomas J. Beene, and the
right, title and interest of any other person to said vehicle is hereby extinguished. The
Commonwealth of Pennsylvania, Department of Transportation may accept this Order as
evidence of ownership in lieu of a Certificate of Title. The Petitioner shall submit the
appropriate forms, taxes, and fees and comply with any other procedures of the
Commonwealth of Pennsylvania, Department of Transportation in order to receive the
appropriate Certificate of Title for the said vehicle.
BY THE COURT,
Christyjee L. Peck, J.
'/ Thomas J. Beene
27 Front Street
Lemoyne, PA 17043
Petitioner, pro Se
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