1W7 ,65.A /.".■ •■ ...■ ••■ •••■

TEXAS SALVAGE VEHICLE TITLE TEXAS DEPARTMENT OF MOTOR VEHICLES

0r TxD(MV

2831201

VEHICLE IDENTIFICATION NUMBER YEAR MODEL MAKE OF VEHICLE BODY STYLE MODEL

KNDJT2A28B7195413 2011 KIA LL SOU 4

TITLE DOCUMENT NUMBER DATE ISSUED

29727042144104032 05/25/2015 4

WEIGHT LICENSE NUMBER PREVIOUS TITLE STATE ODOMETER READING

2900 CL1C239 TX 53520 PREVIOUS OWNER

PAT SIMMONS GLEN ROSE, TX

OWNER

TEXAS FARM BUREAU CASUALTY INSURANCE COMPANY 204 MARS RD WILMER, TX 75172

REMARK IS)

ACTUAL MILEAGE

4

DATE OF LIEN

NONE

LIENHOLDER

IT IS HEREBY CERTIFIED THAT THE PERSON HEREIN NAMED IS THE OWNER OF THE VEHICLE DESCRIBED ABOVE, WHICH IS SUBJECT TO THE ABOVE LIEN.

TRANSFER OF OWNERSHIP RESTRICTIONS: Certain restrictions apply to the sale or transfer of this vehicle. Contact the Texas Department of Motor Vehicles (TxDMV) Vehicle Titles and Registration Division (VTR) in Austin, Texas or the nearest TxDMV Regional Service Center for clarification of these restrictions.

REBUILDER INSTRUCTIONS: The owner responsible for rebuilding this vehicle (licensed salvage dealers excluded) must file an application with the appropriate County Tax Assessor-Collector for a regular certificate of title. The application must be supported by this Salvage Vehicle Title (properly assigned) and a completed Rebuilt Vehicle Statement (Form VTR-61), executed by the rebuilder/owner of the vehicle that includes the vehicle inspection certificate number and expiration date showing a vehicle safety inspection has been conducted by an authorized state inspection station after the rebuilding of the vehicle. The owner must also certify, on the Form VTR-61, that the vehicle identification number affixed to the rebuilt motor vehicle is the same as the vehicle identification number disclosed on the Form VTR-61. At the time of application, a $65 Rebuilt Salvage fee will be assessed in addition to any regular title and registration fees. NOTE: If this vehicle is rebuilt and registered and titled in a state other than Texas, the owner will be required to follow that state's salvage procedure.

VTR-222-S (Rev. 2/2015) DO NOT ACCEPT TITLE SHOWING ERASURE, ALTERATION, OR MUTILATION.

4

4

4

A A A A A A A A A

1'

0

INSURANCE COMPANY 204 MARS RD WILMER, TX 75172- Stock4:15125808 85895922-01 Sale Document (Front)

DETACH HERE

TEXAS FARM BUREAU 111111111111111111#11111111111111111111111111111111111

111111 111111111111 111111111111111111111 111111111 1111111 1111111 111111111 Stock#:15125808 85895922-01 Sale Document CBack)

Upon receipt, your registration is appl

Juilt Salvage" will be issued. If

∎

If you have repaired or rebuilt your salvage vehicle, you may submit the following to your local County Tax

Assessor-Collector's office:

• Texas Salvage Vehicle Title

• A completed Form 130-U, Application for Texas Title

• A completed Form VTR-61, Rebuilt Vehicle Statement, showing vehicle safety inspection after the vehicle is rebuilt

• Proof of liability insurance

• A $65 Rebuilt Salvage fee, your title application fee (either $28 or $33) and any other applicable fees and forms

Forms available at www.txdmv.gov . For more information, contact your local County Tax Assessor-Collector's office.

,- - FEDERAL AND STATE LAW REQUIRES THAT YOU STA=TE THE MILEAGE IN CONNECTION WITH THE TRANSFER OF OWNERSHIP - FAILURE TO COMPLETE--Qt PROVIDING A FALSE STATEMENT MAY RESULT IN FINES AND/OR IMPRISONMENT.

AS

SIG

NM

ENT

OF

S

AL

VAG

E V

EH

ICLE

TIT

LE

The ig hereby certifies that the vehicle described in this certificate=le tee and clear of all liens and has been transferred to the following printed Ttlfne and address:-;

(1 ,-..\ nokIti -vi-ktk(\esA\v,1 -t,... Koetok\ovik- Name of Purchaser Street I certify to the be , -, ge the odometer reading is the actual mileage of the

111011' U 1. The mileage stated

J 2. The odometer o (No Tenths)

— i

City State Zip

vehicle unless one of tWollowing staternentsiis checked -

is in excess of its mechanical limits. reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY

- J. Pries . Date Sale i 3). 101, • 6 • 411001 ...--

Siin e of Seller/Ag- 416

HAND PRINTED NAME (same as signature)

I am aware of the above odometer k seller/agent. IA M'1/4-1C.1 Mne-lt.ci Q

-

Sig - zi iD NAME (same as s ■ nnat,le) -_-_,-, _,,

= , -,

FIR

ST

RE

AS

SIG

NM

EN

OF

SA

LVA

GE

VE

HIC

LE

TI1

LE

,...„Tlie u2clersiinedlrely Tiflis that ' nW this r' , VSX.3°•-. 1,

. ' ■ -- ,- -' name and addtess - • • 1-- , I C) ,----i k IN.\

Name of Purchaser ----..-- 4 qty to the beSt

Purchaser_ my knowledge that the odometer r eading is the actu“ . I of

- to. 538 zo ...1 1. The mileage stated -

_.1 2. The odometer

ODOMETER READING (No Tenths)

State Zip e vehicle -Lunless of . - , , . ,g statements is checked.

is in= excess of ite-meettertical limits, `- reading isnot the actual mkage. WARNING - ODOMETER DISCREPANCY

Date', -1- -Anni Mt\-trc Sale( 911C

05,15/E 1 L..E tr) 7.1.4,1c, Nam 4

as

Name

b H MirnA OZA I t?—* Firm

Si llgal P4

HAND PRINTED NAME (same as signature) I am aware of the above odometer certifica made y the sellertagent -

Signature of Buyer/Agent ; HAND PRINTED NAME (same as signature)

SE

CO

ND

RE

AS

SIG

NM

ENT

OF

SA

LVA

GE

VE

HIC

LE T

ITLE

The undersigned hereby certifies that the vehicle described in this certificate is free and clear of all liens and has been transferred to the following printed name and address:

Nail Purchaser 1, - - Street C -=, - State Zip I cellify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of thelollowing statements is checked'

1101111' .3 1. The mileage stated is in excess of its mechanical limits. J 2. The odometer reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY

ODOMETER READING (No Tenths)

Date of SALVAGE DEALER No. Sale

-- Firm Name Signature of Seller/Agent HAND PRINTED NAME (same as signature)

I am aware of the above odometer certification made by the setter/agent.

Signature of Buyer/Agent HAND PRINTED NAME (same as signature)

THIR

D R

EA

SS

IGN

ME

NT

OF

S

ALV

AG

E V

EH

ICLE

TIT

LE

The undersigned hereby certifies that the vehicle described in this certificate is free and clear of all liens and has been transferred to the following printed name and address:

Nubile of Purchaser Street City - State Zip

I certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the fallowing statements is checked.

11101' J 1 The mileage stated is in excess of its mechanical limits = - - __I 2 The -odometer reading is not the actual mileage. WARNING - ODOMETER DISTREPANCY

ODOMETER READING (No Tenths)

Date of SALVAGE DEALER No:- Sale

Firm Name

Signature of Seller/Agent HAND PRINTED NAME (same as signature) I ati4were of the above odometer certification made bythe seller/agent.

Signature of Buyer/Agent HAND- PRINTED NAME(same as signature)

LIENHOLDER TO BE RECORDED AND SHOWN ON NEW TITLE:

1 ST LIEN IN FAVOR OF (NAME AND ADDRESS)

IF THIS VEHICLE IS TO BE REBUILT, REFER TO THE "REBUILDER INSTRUCTIONS" ON THE FRONT OF THIS DOCUMENT.

ALTERATIONS WILL VOID THIS FORM

Page 1Page 2