STATE OF CALI EORN IA
VEHICLEA/ESSELTRANSFERANDREASSIGNMENTFORM 24o7sg
INSTRUCTIONS ON REVERSE SIDE
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ALL SIGNATURES MUST BE IN INK _ PHOTOCOPIES Nf,I5I@EPTED This lorm is not the certificate.lt must the titling document or ACOUISITION NUMBEH (D/SMANTLER ON LN for For Car Bill of visit
SECTION 1 _ VEHICLEA/ESSEL
MOTORCYCLE ENGINE NUMBER
lANe Galpin Motors lnc sell, transfer, and deliver the above vehicle/vessel IJJ
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a to City Of Redondo Beach
PRINT SELLEB'S NAME(S)
on for the amount of II
o PBINT BUYER'S NAME(S) MO DAY YEAF
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lf this was a gift, indicate relationship N/A (e.9., parents, spouse, friend, etc.) (GIFTVALUE)
Federal and State Law requires that you state the mileage upon trcnster of ownership. Failure to complete or providing a false statement may result in fines andlor imprisonment.
The odometer now reads (no tenths) miles, and to the best of my knowledge reflects the ACTUAL mileage unless one of the following statements is checked.
WARNING_ODOMETER DISCREPANCY
E Odometer reading is NOT the actual mileage n Mileage EXCEEDS the odometer mechanical limits Explain odometer discrepancy
BUYER'S SECTION
I acknowledge the
the laws of the Sta
facts of the transfer.l certify (or declare) under penalty of perjury under is true and correct.
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DUID OB DEALER/DISM fl
DL,/ID OF OEALER/DISM #
DUI OR DEALER/DISI\4 #
DAYTIME TELEPHONE NO
(310) 318-0686
SELLER'S SECTION
I certify (or declare) under penalty of perjury under the laws ol the Sfate of Calilornia that the loregoing is true and correct.
DUID OF OEALEH/DISM #
2787
DUID OR DEALEB/DISI,4 #
DUID OR DEALER/D|S|\,1 #
DAYTIIVE TELEPHONE NO
(818) 787-3800
SECTION 5 _ POWEH OF ATTORNEY
City Of Redondo Beach
l/VVe
PRINT NAME(S)
as my attorney in fact, to complete all necessary documents, as needed, to transfer ownership as required by law.
DATE
0510712024
SIGNATUHE REOUIHEO
x
. Galoin Motors lnc
appornt
IDENTIFICATION NUMBER YEAR MODEL MAKE LICENSE PLATE/CF NO. 2024
Explorer
Ford
1 FMSKSGCORGAI 8769
2 SALE
PRINT BUYER'S NAME SIGNATUBE
x
05t07t2024
DATE
PFINT BUYER'S NAME SIGNATURE
x
DATE
SIGNATURE
x
DATE
BUYER'S I,IAILING ADDRESS ZIP CODE
531 N Gertruda Ave Redondo Beach
NAN,IE
CITY cA 90277
Galpin Motors lnc
PRINT SELLER'S NAME SIGNATUEE
x 05t07t2024
DATE
PFINT SELLEB'S NAME SIGNATUFE
x
DATE
PHINT SELLEF'S NAME S GNATUFE
x
DATE
15505 Roscoe Blvd North Hills CA 91343
SELLER'S MAILING ADDRESS CITY STATE ZIP CODE
SIGNATURE BY PERSON APPOINTING POWER OF ATTORNEY
x
05 7 2044 $
$
2 8
BEG 262 (BEV 10/2011)
APPOINTING POWEP OF ATTORNEY DATE
SECTION 3
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ODOMETER DISCLOSURE STAf,EMENT (Void if Mileage is Altered or Erased) m
SECTION 4
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BUYER AND SELLER (MUSI hand print his or her name,date and srgn this section.) City of Redondo Beach James A. Light
Jeff Llacuna
i
..JEHICLEA/T,SELTRANSFT J
AND BEASSIGNMENT FORM INSTROCTIONS
rH,S FOPM
'S 'VOf
THE OWNERSHIP CERT'FICATE. IT MUSI ACCOMPANY THETITLE OR APPL'CAT'ON FOR A DUPLICATE IITLE. PHOIOCOPIES OFTHE FORM MAY BE REIAINED FOR YOUP FECOPDS.
Know your rights before you sign. Read the Cat Buyet's Bi ol Rights (FFVR 35) and What you Need to Know Belorc Buying a Vehicle (FFVR 26) brochures and other brochures available al www.dmy.ca.gov.
SECTION .I _ VEHICLE/VESSEL IDENTIFICATION
This section must be completed.
SECTION 2 _ BILL OF SALE
To be completed by the seller of the vehicle/vessel, identifying the buyer and/or gift recipient, the purchase price or gift value, and date of sale and/or gift.
SECTION 3 _ ODOMETER DISCLOSURE STATEMENT
To be completed by the seller disclosing the mileage at the time of sale. Any alteration (write-over, cross-out, erasure, deletion, etc.), made to the reported mileage will VOID the odometer disclosure section of this document and a new odometer statement (including the signature of both parties) is mandatory. Photocopies may be retained for personal record. Dealers and Auto Auctions are required to relain a photocopy of the odometer disclosure for 5 years.
Federal law requires the hand printed name, date and signature of the buyer and seller when disclosing and acknowledging the odometer reading.
SECTION 4
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BUYER/SELLEH INFOBMATION (lndividual[s], Company, Dealership, Lessor/Lessee ot lrust) To be completed by the buyer to provide name and address, accept the responsibility of ownership, and/or acknowledge mileage reported. To be completed by the seller to provide name and address, release ownership, and/or disclose mileage to the buyer.
NOTE: Co-owners joined by 'AND" (shown by "/'on DMV records) require the signature of EACH owner; co-owners ioined by "OR" require the signalure of at least ONE owner. The signature for a company or business MUST include the printed name oI the company/business and an authorized represenlative's countersignature on the signature line (e.9., ABC CO., by JOHN SMITH - ot - JOHN SMTTH for ABC CO.\.
SECTION 5 _ POWER OF ATTORNEY
To be completed when appointing a person or company to act as an attorney-injact, to sign papers and documents that may be necessary in order to secure Calilornia registration ol or to transfer my/our interest in the identified vehicle or vessel. The odometer disclosure statement cannot be completed by power ol attorney.
INSTRUCCIONES PARA COMPLETAR ESTE FORMULARIO
ESTE FORMULAR.IO NO ES EL CERTIFICADO DE PROPIEDAD. ESIE OEAEAA ACOMPAfrAR ALfiTULO O LA SOL'CITUD PARA DIIPLICADO DET/TULO, PUEDE GIIARDAR FOTOCOP'AS DE ESTE FORMULARIO PARA SU ARCH'VO PERSONAL.
Conozca sus derechos antes de tirmar. Lea los folletos "Declaracion de Derechos delComprador de Vehiculos" (FFVR 35)y"Oud Necesita Saber Antes de Comprar un Vehiculo" (FFVR 26) y otros tolletos disponibles en wmr. dmv,ca.gov.
SECCION 1 _ IDENTIFICACIoN DE VEHiCULO/BAFCO
Esta seccion debera completarse.
SECCI6N 2 _ FACTURA DEVENTA
Para completarse por el vendedor del vehiculo/barco, para identificar al comprador y/o receptor del regalo, el precio de compra o valor del regalo y la fecha de la venta y/o regalo.
SECCI6N 3 _ DECLARACI6N DEL BECORRIDO EN MILLAS DEL OD6METRO Para completarse por el vendedor declarando el millaje al momento de la venta. C.ualquier alteraci6n (escribir sobre el texto, tachar texto, borraduras, omisiones, etc.) que se haga al millaje reportado ANULARA la secci6n de la declaraci6n del od6metro de este documento y sera obligatorio presentar una nueva declaraci6n (incluyendo la firma de ambas partes). Puede conservar fotocopias para su archivo personal. A los concesionarios y subastadores de autos se les exige conservar una fotocopia de Ia declaraci6n del od6metro por cinco (5) ahos.
La ley lederal exige que el nombre sea escrito a mano asi como la fecha y la firma del vendedor y del comprador cuando se declare y conf irme la leclura del millaje del od6metro. sEcct6N 4
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tNFoRMAC|6N SOBRE EL COMPRADOR/VENDEDOR(lndivivduotsl,compafrb,concesiona o,Anendata ol Arren dad or o F icleicomiso)
El comprador deber6 llenar esta secci6n a fin de proveer su nombre y direcci6n, aceptar responsabilidad del vehiculo/barco y/o reconocer el millaje reportado. El vendedor debera llenar esta secci6n a tin de proveer al comprador su nombre y dilecci6n, relevar la responsabilidad del yehiculo/barco y/o declarar el millaje al comprador.
NOTA: Para los co-propietarios unidos por la letra "Y" (mostrado en el titulo con una barra'7') se exige la firma de CADA propietario; los co-piopibtarios unidos por la letra "O" exige la lirma de por lo menos UN propietario. La firma de una compai[a b nbgocio DEBE incluir el nombre impieso de la compafria o negocio y la contra-lirma de un agente autorizado en el regl6n de la firma (eiemplo:A BC CO, pot JOHN SMITH 'o bien - JOHN SMITH por ABC CO.\.
SECCIoNs _ PODER LEGAL
Esta seccion debera llenarse cuando se asigna una persona o compaflia para actuar como apoderado para firmar papeles y documentos que puedan ser necesarios pira asegurar la matricula de California o para traspasar mi/nuestro inter6s en el vehiculo o barco identificado.
Esta secci6n de poder legai no puede usarse para la declaraci6n del od6metro FEG 262 (BEV 102011)
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