Motor Vehicle Bill of Sale Form - Northwest Territories Canada

Canada
MOTOR VEHICLE BILL OF SALE (Please type or print
in BLOCK LETTERS)
BLOCKS “AAND “B” MUST BE COMPLETED TO RENDER THIS BILL OF SALE
ACCEPTABLE FOR VEHICLE REGISTRATION. BLOCK “C” IS OPTIONAL
A
THIS IS TO CERTIFY THAT I, THE SELLER
NAME Surname Given name(s)
PHONE NO.
ADDRESS Number & Street City/Town
Province/Territory Postal Code
PERSONAL IDENTIFICATION - NUMBER
TYPE – (eg OPERATOR’S LICENCE) l
DO HEREBY SELL MY VEHICLE DESCRIBED AS FOLLOWS
MANUFACTURER YEAR MAKE MODEL PLATE NO. ODOMETER READING
SERIAL NUMBER (VIN) VEHICLE BODY COLOR VEHICLE ROOF COLOR
TYPE OF VEHICLE – ENTER “X” OFF-HIGHWAY VEHICLES
____ 2 DOOR SEDAN ____ MOTORHOME ____ FARM TRACTOR ____ ALL-TERRAIN VEHICLE
____ 4 DOOR SEDAN ____ UTILITY VEHICLE ____ HEARSE ____ MINI-AUTO
____ CONVERTIBLE ____ MOPED ____ SERVICE RIG ____ MINI-BIKE (2 WHEELS)
____ HATCHBACK ____ MOTORCYCLE ____ TRUCK ____ MOTORCYCLE
____ SPORTSCAR ____ AMBULANCE ____ TRUCK/TRAILER ____ SNOW VEHICLE
COMBINATION
____ STATIONWAGON ____ BUS
____ VAN _____ SCHOOL BUS
TRAILERS - _____ PUBLIC SERVICE/COMMERCIAL ____ UTILITY (PERSONAL USE) ____ BOAT ____ TENT
TO THE FOLLOWING BUYER:
NAME Surname Given Name(s) PHONE NO.
ADDRESS
VEHICLE SOLD
FOR SUM OF -
$
(SUBJECT TO THE TERMS & CONDITIONS SPECIFIED IN BLOCK “C”, IF ANY) l $
B
I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE
DATED THIS ___________________ DAY OF ___________________, 20___ TO THE BEST OF MY KNOWLEDGE AND UNDERSTANDING
AT _____________________________________________________________ _____________________________________________________
SELLER
IN THE PROVINCE/TERRITORY OF __________________________________ _____________________________________________________
SELLER
'S WITNESS
IN THE C
OUNTRY OF _____________________________________________ _____________________________________________________
BUYER
____________________________________________________
BUYER’S WITNESS
C
(OPTIONAL) SPECIAL CONDITIONS OF SALETHE VEHICLE DESCRIBED ABOVE IS
1. FREE OF ALL LIENS AND ENCUMBRANCES? YES NO
IF NO, NAME OF LIEN HOLDER IS __________________________________________________________________________________________
MONEY
OTHER
2. PAID IN FUL
L? YES NO PAID BY
CASH CHEQUE ORDER (SPECIFY)____________________________
3. PA
YMENT TERMS? YES NO IF YES, SPECIFY __________________________________________
___________________________
4. WHERE WAS VEHICLE LAST
REGISTERED? _________________________________________________________________
_________________
5. SPECIAL CONDITI
ONS OF SALE? YES NO IF YES, SPECIFY _________________________________________________________
____ OTHER VEHICLE - DESCRIBE
Page 1/2
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