AMK Auto Parts Sales & Service Inc.

425 John Ward Rd, Lexington, NC 27295

Phone: 336-237-0885 Fax: 336-217-8030
VEHICLE BILL OF SALE

AFFIDAVIT

I, __________________________________ resident of _____________________________________ City

__________________________________ state __________ ID #________________________

Exp. ____________________________ hereby state that under oath that:

I, _____________________________________ and _______________________________ are owners of the

vehicle: Make ________________________ Model _________________________ Year _________

VIN # _____________________________________________ color _________________ that I am selling my

vehicle to AMK Auto Parts Sales & Service Inc, in the amount of $________________ that I lost or could not find

my title at the time and will mail it later. I authorize AMK Auto Parts Sales & Service Incs driver

Mr._____________________________ to pick up my car which is parked at

_____________________________________________________________________________________________

I certify that the vehicle described above is free and clear of all liens and is owned by me, or the company that I
work for, and is sold to AMK Auto Parts Sales & Service Inc, for scrap metal or for parts only. I acknowledge that the
information concerning the sale of this vehicle will be reported to the Federal, State, and Local authorities and that
any title for this vehicle will be canceled.

I agree to reimburse AMK Auto Parts Sales & Service Inc, for any damages, attorney fees, court costs, or other
expenses incurred on account of an in the vent that any of the information that I have provided is false, or that I am
not legally entitled to sell this vehicle

Seller Sign Here: ________________________________________ Date: ________________________

Witness: _______________________________________________ Date: ________________________