HomeMy WebLinkAboutInv# PC - 22538 - BROWARD COUNTY TAX COLLECTOR - 10/31/2024Broward County Records, Taxes & Treasury Div.
Broward County Tax Collector 115 S. Andrews Ave. Room A100 Fort Lauderdale, FL 33301
Transaction # 18539926
Cashier:
--------------------------
BO
Paid By:
CITY OF_DA_NIA_BEACH/ YAMIL LOBO
^'10/31/2024
Posted Date:
09:49AM
Received Via �-
-------------------------
In Person - -
Num. Items:
8
Total Tendered -
$470.20
Receipt M
-_--- --^
003-24-00000140
_---602721
Batch:-
Drawer:
3
Status:--__W
--Complete --
_ A',' t*d'ri'gu�a�lent ay:
Fernando
ervices Director
puWW,S _-- -
Receipt
Item
Details
Effective
Due
Paid
Date
_
FRVIS
Plantation
-----____
10/31/2024
$78.25
_
_ - $78.25
Batch# 2685209
VIN:
3FTTW8H95RRB51040
FRVIS
__C_ode:_O_RT
Plantation -^�-
�10/31/2024
_
$78.25
________
$78.25
Batch# 2685209
VIN:
3FTTW8H91 RRB50919
C_o_de:_O_RT
-
FRVIS
-PlantationT-.
10/31/2024
$78.25---
-
$78.25
Batch# 2685209
VIN:
3FTTW8H98RRB50948
____
_FRVIS
_C_ode:_O_RT
Plantation- - �10/31/2024
$39.30
--�- $39.30
Batch# 2685209
VIN:
3FTTW8H91 RRB50919
_
___C_o_de:_O_RR___
FRVIS_
Plantation
10/31/2024
$39.30
$39.30
Batch# 2685209
VIN:
3FTTW8H98RRB50948
____
FRVIS _
lCode:ORR
Plantation
____ __
10/31/2024
$39.30�--
-- $39.30
Batch# 2685209
VIN:
3FTTW8H95RRB51040
Code:ORR
FRVIS _'Plantation
- -- �10/31/2024
$39.30
_ - $39.30
Batch# 2685209
VIN:
3FTTW8H93RRB50887
Co_de:_ORR
-
FRVIS -
--P_lantation ---10/31/2024
$78.25
$78.25
Batch# 2685209
VIN:
3FTTWBH93RRB50887
Code: ORT
-------.�_--____-_
__-
Total:
---- -
_ -___..�__
$470.20_
_.
$4_7.-0.2--
0
Payment -!Details
Paid
Credit
Credit or
Visa CC#XXXX-6692 _
s
$470.20
Debit Card
Confirmation number:
J9827470769
AID:A0000000031010
TDS:emv
Application Label: VISA
CREDIT
PIN Statement: 1
Auth Code: 065836
Balance:
$0.00
Convenience
$11.99-I
Fee:
— ----
- J
Total $482.19
Charged:
MT"S020
IMPORTANT INFORMATION
Section 316.613, Florida Statutes, requires every operator of a motor vehicle transporting
a child in a passenger car, van, autocycle or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide the protection of the child by properly using a crash -tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat. For children aged 4 through 5 years,
a separate carrier, an integrated child seat, or a child booster seat may be used.
(/ For limited exceptions, see s. 316.613, F.S.
S. 320.0605, F.S., requires the registration certificate, or true copy of a rental or lease
agreement, issued for any motor vehicle to be in the possession of the operator or carried in
the vehicle while the vehicle is being used or operated on roads of this state.
S. 320.02 and 627.733, F.S., requires personal injury protection and property damage
liability to be continuously maintained throughout the registration period. Failure to maintain
the mandatory coverage may result in the suspension of your driver license and registration.
Mail To:
CITY OF DANIA BEACH Important note: If you cancel the insurance for this vehicle,
1201 STIRLING RD immediately return the license plate from this registration to a Florida
DANIA BEACH, FL 33004 driver license or tax collector office or mail it to: DHSMV, Return Tags,
2900 Apalachee Parkway, Tallahassee, FL 32399. Surrendering the plate
will prevent your driving privilege from being suspended.
CO/AGY 10 / 6 T# 2037241697
iLORIDA VEHICLE REGISTRATION B# 2685209
'LATE XL8646 DECAL Expires NO EXPIRATION
R/IvIIC 2024/FORD BODY PK
"IN 3FTTWBH95RRB51040
late Type CVR NET WT 3416
L/FEID -
ate Issued 10/31 /2024 Plate Issued 10/31 /2024
ITY OF DANIA BEACH
201 STIRLING RD
ANIA BEACH, FL 33004
✓R - CITY VEHICLES PLATE ISSUED X
COLOR WHI Reg. Tax 36.30 Class Code 97
TITLE 156733282 Init. Reg. Tax Months 12
County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
Sales Tax Credit Months
Voluntary Fees
Grand Total 39.30
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
a replacement vehicle.
3. Your registration must be updated to your new address within 30 days of moving.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
5. 1 understand that my driver license and registrations will be suspended
immediately if the insurer denies the insurance information submitted
for this registration.
CNN# AGY# SUB# RPT# °FT'U3�TN�� 1111 L ���11 II I
L# 4170765
10 6 BAC 6537 = ' ' T# 2037240901
STATE OF FLORIDA B# 2685209
AUDIT# ate' APPLICATION FOR VEHICLE/VESSEL S# 109235952
-- CERTIFICATE OF TITLE -- - —
TITLE NUMBER VEHICLEIVESSEL IDENTIFICATION # YR. MAKE MAKE or BODY VEHICLE COLOR WT/LENGTH PRINCPL GVW/LOC
MANUFACTURER TYPE OPERAT
156733282 3FTTW8H95RRB51040� 2024 FORD T PK WHI [3416
DATE OF ISSUE TRANS VEHICLE USE HULL PROPULSION ENGINE FUEL VESSEL WATER FL NUMBER AUTH
MO. DAY YEAR CODE MATERIAL DRIVE TYPE DESTRUCTION
K31124 [ORT PRIVATE-
Applicant/Owners Name & Address
CITY OF DANIA BEACH
1201 STIRLING RD
DANIA BEACH, FL 33004
.�f S I 23
VOLUNTARY CONTRIBUTIONS
Action Requested: ORIGNEW TITLE
BIRTHDATE RESIDENT CNTY
SEX MO. DAY YEAR Y N ALIEN RES.#
L�T��Lx-T-F]_L.
-I
tsl OWNER FUDL# OR 2nd OWNER FUDL# OR
F.E LD.# UNIT #
AGENCY TITLE FEE SALES TAX GRAND TOTAL
FEE
JK755] 73.50 0.00� I--- 78.25]
Brands: E
PREV STATE
DATE ACQUIRED
NEW
USED
ODOMETER / VESSEL MANUFACTURER ODOMETER
DECLARATION
CERTIFICATION
10/15/2024
XX
35 MI 10/15/2024 ACTUAL _ - _ ❑
LIEN INFORMATION
NAME OF FIRST LIENHOLDER:
ADDRESS
DATE OF LIEN RECEIVED DATE FEID # OR FL / DLAND SEXAND DATE OF BIRTH C
SELLER INFORMATION
NAME OF SELLER, FLORIDA DEALER, OR OTHER PREVIOUS OWNER
ADDRESS
DEALER LICENSE NO.
SALES TAX AND USE REPORT
TRANSFER OF TITLE ® PURCHASER HOLDS VALID
IS EXEMPT FROM EXEMPTION CERTIFICATE
FLORIDA SALES OR ❑ VEHICLE / VESSEL WILL BE
USE TAX FOR THE USED EXCLUSIVELY FOR RENTAL
REASON(S) CHECKED ® OTHER EXEMPT
SALVAGE TYPE
CONSUMER OR SALES TAX EXEMPTION # 85-8015921280C9
INDICATE TOTAL PURCHASE PRICE, INCLUDING ANY $
UNPAID BALANCE DUE SELLER, BANK OR OTHERS
INDICATE SALES OR USE TAX DUE AS PROVIDED BY CHAPTER $ 0.00
212, FLORIDA STATUTES
❑ SELLING PRICE VERIFIED
APPLICANT CERTIFICATION
IME HEREBY CERTIFY THAT THE VEHICLENESSEL TO BE TITLED WILL NOT BE OPERATED UPON THE PUBLIC HIGHWAYSAVATERWAYS OF THIS STATE.
I CERTIFY THAT THE CERTIFICATE OF TITLE IS LOST OR DESTROYED.
I CERTIFY THAT THIS MOTOR VEHICLENESSEL WAS REPOSSESSED UPON DEFAULT OF THE LIEN INSTRUMENT AND IS NOW IN MY POSSESSION.
IN/E HEREBY CERTIFY THAT IME LAWFULLY OWN THE ABOVE DESCRIBED VEHICLENESSEL, AND MAKE APPLICATION FOR TITLE. IF LIEN 15 BEING RECORDED NOTICE IS HEREBY GIVEN THAT THERE IS AN
EXISTING WRITTEN LIEN INSTRUMENT INVOLVING THE VEHICLENESSEL DESCRIBED ABOVE AND HELD BY LIENHOLDER SHOWN ABOVE. IME FURTHER AGREE TO DEFEND THE TITLE AGAINSTALL CLAIMS.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Signature of ApplicanUOwner
Signature ofApplicanUCo-Owner
HSMV 82041 REVISED 02/06 SCAN CODE MVT
I UNDERSTAND THAT MY DRIVER LICENSE AND REGISTRATIONS WILL BE SUSPENDED IMMEDIATELY IF THE INSURER DENIES
THE INSURANCE INFORMATION SUBMITTED FOR THIS REGISTRATION.
MTRFS021Y
MTRFS020
IMPORTANT INFORMATION
Section 316.613, Florida Statutes, requires every operator of a motor vehicle transporting
a child in a passenger car, van, autocycle or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide the protection of the child by properly using a crash -tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat. For children aged 4 through 5 years,
a separate carrier, an integrated child seat, or a child booster seat may be used.
For limited exceptions, see s. 316.613, F.S.
S. 320.0605, F.S., requires the registration certificate, or true copy of a rental or lease
agreement, issued for any motor vehicle to be in the possession of the operator or carried in
the vehicle while the vehicle is being used or operated on roads of this state.
S. 320.02 and 627.733, F.S., requires personal injury protection and property damage
liability to be continuously maintained throughout the registration period. Failure to maintain
the mandatory coverage may result in the suspension of your driver license and registration.
Mail To:
CITY OF DANIA BEACH Important note: If you cancel the insurance for this vehicle,
1201 STIRLING RD immediately return the license plate from this registration to a Florida
DANIA BEACH, FL 33004 driver license or tax collector office or mail it to: DHSMV, Return Tags,
2900 Apalachee Parkway, Tallahassee, FL 32399. Surrendering the plate
will prevent your driving privilege from being suspended.
CO/AGY 10 / 6 T# 2037237657
FLORIDA VEHICLE REGISTRATION B# 2685209
'LATE XL8644 DECAL Expires NO EXPIRATION
r,T MK 2024/FORD BODY PK
'IN 3FTTWBH98RRB50948
late Type CVR NET WT 3416
)L/FEID -
We Issued 10/31/2024 Plate Issued 10/31/2024
ITY OF DANIA BEACH
201 STIRLING RD
ANIA BEACH, FL 33004
VR - CITY VEHICLES PLATE ISSUED X
COLOR WHI Reg. Tax 36.30 Class Code 97
TITLE 156733183 Init. Reg. Tax Months 12
County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
Sales Tax Credit Months
Voluntary Fees
Grand Total 39.30
IMPORTANT INFORMATION
I. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
a replacement vehicle.
3. Your registration must be updated to your new address within 30 days of moving.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
5. I understand that my driver license and registrations will be suspended
immediately if the insurer denies the insurance information submitted
for this registration.
CNTY# AGY# SUB# RPT#tHe-` —� 'III r �' Ir'I Il r T#
C,�I= �.YY 4170762
10 BAC�37 2037237291
I �` STATE OF FLORIDA B# 2685209
AUDIT# npR APPLICATION FOR VEHICLE/VESSEL S# 109235738
CERTIFICATE OF TITLE - ""--
TITLE NUMBER VEHICLENESSEL IDENTIFICATION # YR. MAKE MAKE or BODY VEHICLE COLOR WT/LENGTH
PRINCPL GVW/LOC
MANUFACTURER TYPE
OPERAT
156733183 �3FTTW8H98RRB50948 2024 FORD FPK] WHI�—
I3416
1
t
DATE OF ISSUE TRANS VEHICLE USE
MO. DAY YEAR CODE
—
HULL PROPULSION ENGINE FUEL VESSEL WATER FL NUMBER
MATERIAL DRIVE TYPE
-
"
AUTH
DESTRUCTION
10 E31124] ORT PRIVATE
T—
BIRTHDATE
RESIDENT CNTY
SEX
MO. DAY YEAR Y
N ALIEN RES.#
ApplicanUOwners Name & Address 1 L10j
CITY OF DANIA BEACH
1201 STIRLING RD =XT-_— (i
DANIA BEACH, FL 33004 1st OWNER FL/DL# OR 2nd OWNER FUDL# OR
F.E W.# UNIT#
VOLUNTARY CONTRIBUTIONS
AGENCY
FEE
TITLE FEE SALES TAX GRAND TOTAL
--" - -- _
4.75[----
73.50
E--o-o-o
_- 78.25]
Action Requested: ORIGNEWTITLE
Brands:
PREV.STATE
DATE ACQUIRED
NEW
USED
ODOMETER/VESSEL MANUFACTURER ODOMETER
DECLARATION
CERTIFICATION
10/15/2024
XX
27 MI 10/15/2024 ACTUAL ❑
LIEN INFORMATION DATE OF LIEN RECEIVED DATE FEID # OR FL / OLAND SEXAND DATE OF BIRTH DMVACCOUNT #
NAME OF FIRST LIENHOLDER:
ADDRESS
SELLER INFORMATION
NAME OF SELLER, FLORIDA DEALER, OR OTHER PREVIOUS OWNER
ADDRESS
DEALER LICENSE NO.
SALES TAX AND USE REPORT
TRANSFER OF TITLE ® PURCHASER HOLDS VALID
IS EXEMPT FROM EXEMPTION CERTIFICATE
FLORIDA SALES OR ❑ VEHICLE / VESSEL WILL BE
USE TAX FOR THE USED EXCLUSIVELY FOR RENTAL
REASON(S) CHECKED X OTHER EXEMPT
SALVAGE TYPE
CONSUMER OR SALES TAX EXEMPTION # 85-8015921280C9
INDICATE TOTAL PURCHASE PRICE, INCLUDING ANY $
UNPAID BALANCE DUE SELLER, BANK OR OTHERS
INDICATE SALES OR USE TAX DUE AS PROVIDED BY CHAPTER $ 0.00
212, FLORIDA STATUTES
❑ SELLING PRICE VERIFIED
APPLICANT CERTIFICATION
UWE HEREBY CERTIFY THAT THE VEHICLENESSEL TO BE TITLED WILL NOT BE OPERATED UPON THE PUBLIC HIGHWAYS/WATERWAYS OF THIS STATE.
1 CERTIFY THAT THE CERTIFICATE OF TITLE IS LOST OR DESTROYED.
I CERTIFY THAT THIS MOTOR VEHICLENESSEL WAS REPOSSESSED UPON DEFAULT OF THE LIEN INSTRUMENT AND IS NOW IN MY POSSESSION.
IIWE HEREBY CERTIFY THAT IANE LAWFULLY OWN THE ABOVE DESCRIBED VEHICLENESSEL, AND MAKE APPLICATION FOR TITLE. IF LIEN IS BEING RECORDED NOTICE IS HEREBY GIVEN THAT THERE IS AN
EXISTING WRITTEN LIEN INSTRUMENT INVOLVING THE VEHICLE/VESSEL DESCRIBED ABOVE AND HELD BY LIENHOLDER SHOWN ABOVE. IfWE FURTHER AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN ITARE TRUE.
Signature of Applicant/Owner
HSMV 82041 REVISED 02/06 SCAN CODE MVT
Signature ofApplicanUCo-Owner
I UNDERSTAND THAT MY DRIVER LICENSE AND REGISTRATIONS WILL BE SUSPENDED IMMEDIATELY IF THE INSURER DENIES MTRFS021Y
THE INSURANCE INFORMATION SUBMITTED FOR THIS REGISTRATION.
MTRFS020
IMPORTANT INFORMATION
Section 316.613, Florida Statutes, requires every operator of a motor vehicle transporting
a child in a passenger car, van, autocycle or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide the protection of the child by properly using a crash -tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat. For children aged 4 through 5 years,
a separate carrier, an integrated child seat, or a child booster seat may be used.
For limited exceptions, see s. 316.613, F.S.
I / S. 320.0605, F.S., requires the registration certificate, or true copy of a rental or lease
agreement, issued for any motor vehicle to be in the possession of the operator or carried in
U the vehicle while the vehicle is being used or operated on roads of this state.
S. 320.02 and 627.733, F.S., requires personal injury protection and property damage
liability to be continuously maintained throughout the registration period. Failure to maintain
the mandatory coverage may result in the suspension of your driver license and registration.
Mail To:
CITY OF DANIA BEACH Important note: If you cancel the insurance for this vehicle,
1201 STIRLING RD immediately return the license plate from this registration to a Florida
DANIA BEACH, FL 33004 driver license or tax collector office or mail it to: DHSMV, Return Tags,
-2900 Apalachee Parkway, Tallahassee, FL 32399. Surrendering the plate
will prevent your driving privilege from being suspended.
CO/AGY 10 / 6 T# 2037231513
'LORIDA VEHICLE REGISTRATION B# 2685209
'LATE XL8643 DECAL Expires NO EXPIRATION
11 M 2024/FORD BODY PK
IN 3FTTWBH91RRB50919
late Type CVR NET WT 3416
L/FEID -
ate Issued 10/31/2024 Plate Issued 10/31/2024
ITY OF DANIA BEACH
201 STIRLING RD
ANIA BEACH, FL 33004
✓R - CITY VEHICLES PLATE ISSUED X
COLOR WHI Reg. Tax 36.30 Class Code 97
TITLE 156733050 Init. Reg. Tax Months 12
County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
Sales Tax Credit Months
Voluntary Fees
Grand Total 39.30
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
a replacement vehicle.
3. Your registration must be updated to your new address within 30 days of moving.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
5. I understand that my driver license and registrations will be suspended
immediately if the insurer denies the insurance information submitted
for this registration.
CNTY# AGY# SUB# RPT#
10 6 BAC 6537 -` =
AUDIT #
TITLE NUMBER VEHICLENESSEL IDENTIFICATION #
'III �1.5'rr'.'T'■rr� r '�fir'I III L# 4170753 --- - -
T# 2037230923
STATE OF FLORIDA B# 2685209
APPLICATION FOR VEHICLE/VESSEL I S# 109235384
CERTIFICATE OF TITLE _ - - - ----- -
YR. MAKE MAKE or BODY VEHICLE COLOR WT/LENGTH PRINCPL GVW/LOC
MANUFACTURER TYPE OPERAT
---- — ---]
�56733050 — 3FTTW8H91RRB50919 12024 FORD PK [WV�1--
�416 — �-
DATE OF ISSUE TRANS VEHICLE USE HULL PROPULSION ENGINE FUEL VESSEL WATER FL NUMBER AUTH
MO. DAY YEAR CODE MATERIAL DRIVE TYPE DESTRUCTION
10 n12 ORT PRIVATE
BIRTHDATE RESIDENT CNTY
SEX MO. DAY YEAR Y N ALIEN REST
Applicant/Owner's Name &Address
OF DANIA BEACH
r(�CITY
11-01
1 LX
1201 STIRLING RD
L
DANIA BEACH, FL 33004
1st OWNER FUDL# OR 2nd OWNER FUDL# OR
F.E.I.D.# UNIT #
VOLUNTARY CONTRIBUTIONS
Action Requested: ORIGNEWTITLE
AGENCY
EE
FF
TITLE FEE
SALES TAX GRAND TOTAL
75
73.50
0.00] 78.251
Brands:
_
PREV.STATE
DATE ACQUIRED
NEW
USED
ODOMETER/VESSEL MANUFACTURER ODOMETER
DECLARATIC
CERTIFICATI
10/21/2024
XX
36 MI 10/21/2024 ACTUAL ❑
LIEN INFORMATION
NAME OF FIRST LIENHOLDER:
ADDRESS
N
)N
DATE OF LIEN RECEIVED DATE FEID # OR FL / DLAND SEX AND DATE OF BIRTH DMVACCOUNT #
SELLER INFORMATION
NAME OF SELLER, FLORIDA DEALER, OR OTHER PREVIOUS OWNER
ADDRESS
DEALER LICENSE NO.
SALES TAX AND USE REPORT
TRANSFER OF TITLE ® PURCHASER HOLDS VALID
IS EXEMPT FROM EXEMPTION CERTIFICATE
FLORIDA SALES OR ❑ VEHICLE / VESSEL WILL BE
USE TAX FOR THE USED EXCLUSIVELY FOR RENTAL
REASONS) CHECKED ® OTHER EXEMPT
SALVAGE TYPE
CONSUMER OR SALES TAX EXEMPTION # 85-8015921280C9
INDICATE TOTAL PURCHASE PRICE, INCLUDING ANY $
UNPAID BALANCE DUE SELLER, BANK OR OTHERS
INDICATE SALES OR USE TAX DUE AS PROVIDED BY CHAPTER $ 0.00
212, FLORIDA STATUTES
❑ SELLING PRICE VERIFIED
APPLICANT CERTIFICATION
IME HEREBY CERTIFY THAT THE VEHICLENESSEL TO BE TITLED WILL NOT BE OPERATED UPON THE PUBLIC HIGHWAYSAVATERWAYS OF THIS STATE,
I CERTIFY THAT THE CERTIFICATE OF TITLE IS LOST OR DESTROYED.
I CERTIFY THAT THIS MOTOR VEHICLENESSEL WAS REPOSSESSED UPON DEFAULT OF THE LIEN INSTRUMENT AND IS NOW IN MY POSSESSION.
IME HEREBY CERTIFY THAT IME LAWFULLY OWN THE A80VE DESCRIBED VEHICLENESSEL, AND MAKE APPLICATION FOR TITLE. IF LIEN IS BEING RECORDED NOTICE IS HEREBY GIVEN THAT THERE IS AN
EXISTING WRITTEN LIEN INSTRUMENT INVOLVING THE VEHICLENESSEL DESCRIBED ABOVE AND HELD BY LIENHOLDER SHOWN ABOVE. [ME FURTHER AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Signature of Applicant/Owner
HSMV 82041 REVISED 02/06 SCAN CODE MVT
Signature of ApplicanUCo-Owner
I UNDERSTAND THAT MY DRIVER LICENSE AND REGISTRATIONS WILL BE SUSPENDED IMMEDIATELY IF THE INSURER DENIES
THE INSURANCE INFORMATION SUBMITTED FOR THIS REGISTRATION.
MTRFS021Y
MTRFS020
IMPORTANT INFORMATION
Section 316.613, Florida Statutes, requires every operator of a motor vehicle transporting
a child in a passenger car, van, autocycle or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide the protection of the child by properly using a crash -tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat. For children aged 4 through 5 years,
a separate carrier, an integrated child seat, or a child booster seat may be used.
For limited exceptions, see s. 316.613, F.S.
S. 320.0605, F.S., requires the registration certificate, or true copy of a rental or lease
agreement, issued for any motor vehicle to be in the possession of the operator or carried in
1 the vehicle while the vehicle is being used or operated on roads of this state.
t S. 320.02 and 62 a 7.733, F.S., requires personal injury protection and property dame g
liability to be continuously maintained throughout the registration period. Failure to maintain
the mandatory coverage may result in the suspension of your driver license and registration.
Mail To:
CITY OF DANIA BEACH Important note: If you cancel the insurance for this vehicle,
1201 STIRLING RD immediately retum the license plate from this registration to a Florida
DANIA BEACH, FL 33004 driver license or tax collector office or mail it to: DHSMV, Return Tags,
2900 Apalachee Parkway, Tallahassee, FL 32399. Surrendering the plate
will prevent your driving privilege from being suspended.
CO/AGY 10 / 6 T# 2037227275
,LORIDA VEHICLE REGISTRATION B# 2685209
'LATE XL8642 DECAL Expires NO EXPIRATION
`R/MK 2024/FORD BODY PK
'IN 3FTTWBH93RRB50887
late Type CVR NET WT 3416
)L/FEID -
late Issued 10/31/2024 Plate Issued 10/31/2024
ITY OF DANIA BEACH
201 STIRLING RD
ANIA BEACH, FL 33004
VR - CITY VEHICLES PLATE ISSUED X
COLOR WHI Reg. Tax 36.30 Class Code 97
TITLE 156732967 Init. Reg. Tax Months 12
County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
Sales Tax Credit Months
Voluntary Fees
Grand Total 39.30
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
a replacement vehicle.
3. Your registration must be updated to your new address within 30 days of moving.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
5. I understand that my driver license and registrations will be suspended
immediately if the insurer denies the insurance information submitted
for this registration.
CNTY# AGY# SUB# RPT# . . . . . . 'III
WL# — 4170743
-IOT6 j BA 6537 � q.01P!At Fhll III T# 2037226451
AUDIT# STATE OF FLORIDA B# 2685209
APPLICATION FOR VEHICLE/VESSEL S# 109235124
CERTIFICATE OF TITLE
TITLE NUMBER VEHICLE/VESSEL IDENTIFICATION # YR. MAKE MAKE or BODY VEHICLE COLOR WT/LENGTH PRINCPL GVW/LOC
MANUFACTURER TYPE OPERAT
_4 2024 ]FORD [�Hl 3416�732 67 �� I3FTTW8H93RRB50887
DATE OFISSUE TRANS VEHICLE USE HULL PROPULSION ENGINE FUEL VESSEL WATER FL NUMBER AUTH
MO. DAY YEAR CODE MATERIAL DRIVE TYPE DESTRUCTION
EORT]PRIVATE
BIRTHDATE RESIDENT CNTY
Applicant/Owner's Name &Address SEX MO. DAY YEAR Y N ALIEN RES�#
CITY OF DANIA BEACH101
L-I-= I-X1-
1201 STIRLING " -1- --,-
DANIA BEACH, FL 33004 lsl OWNER FUDL# OR 2nd OWNER FL DL# OR
F.E.I.04 UNIT#
VOLUNTARY CONTRIBUTIONS
AGENCY TITLE FEE SALES TAX GRAND TOTAL
FEE
11
-- 4.75 73.50 0.00 78.25
Action Requested: CRIGNEWTlTLE Brands:
PREV. STATE DATE ACQUIRED NEW USED ODOMETER I VESSEL MANUFACTURER ODOMETER
DECLARATION
CERTIFICATION
10/21/2024 XX 36 MI 10/21/2024 ACTUAL ❑
LIEN INFORMATION DATE OF LIEN RECEIVED DATE FEID # OR FL / DLAND SEX AND DATE OF BIRTH DMVACCOUNT #
NAME OF FIRST LIENHOLDER:
ADDRESS SALVAGE TYPE
SELLER INFORMATION
NAME OF SELLER, FLORIDA DEALER, OR OTHER PREVIOUS OWNER
ADDRESS
DEALER LICENSE NO.
CONSUMER OR SALES TAX EXEMPTION # 85-8015921280C9
SALES TAX AND USE REPORT INDICATE TOTAL PURCHASE PRICE, INCLUDING ANY $
UNPAID BALANCE DUE SELLER, BANK OR OTHERS
TRANSFER OF TITLE PURCHASER HOLDS VALID
IS EXEMPT FROM EXEMPTION CERTIFICATE INDICATE SALES OR USE TAX DUE AS PROVIDED BY CHAPTER $ 0.00
FLORIDA SALES OR ❑ VEHICLE / VESSEL WILL BE 212, FLORIDA STATUTES
USE TAX FOR THE USED EXCLUSIVELY FOR RENTAL
REASON(S) CHECKED OTHER EXEMPT ❑ SELLING PRICE VERIFIED
APPLICANT CERTIFICATION
[ME HEREBY CERTIFY THAT THE VEHICLENESSEL TO BE TITLED WILL NOT BE OPERATED UPON THE PUBLIC HIGHWAYSMATERWAYS OF THIS STATE.
I CERTIFY THAT THE CERTIFICATE OF TITLE IS LOST OR DESTROYED.
I CERTIFY THAT THIS MOTOR VEHICLEIVESSEL WAS REPOSSESSED UPON DEFAULT OF THE LIEN INSTRUMENT AND IS NOW IN MY POSSESSION.
TfW—E HEREBY CERTIFY THAT VWE LAWFULLY OWN THE ABOVE DESCRIBED VEHICLE/VESSEL, AND MAKE APPLICATION FOR TITLE. IF LIEN IS BEING RECORDED NOTICE 15 HEREBY GIVEN THAT THERE IS AN
EXISTING WRITTEN LIEN INSTRUMENT INVOLVING THE VEHICLEfVESSEL DESCRIBED ABOVE AND HELD BY LIENHOLDER SHOWN ABOVE. [ME FURTHER AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
Signature ofApplicant/Owner Signature ofAppliGantICo-Owner
HSMV 82041 REVISED 02/06 SCAN CODE MVT
I UNDERSTAND THAT MY DRIVER LICENSE AND REGISTRATIONS WILL BE SUSPENDED IMMEDIATELY IF THE INSURER DENIES MTRFS021 Y
THE INSURANCE INFORMATION SUBMITTED FOR THIS REGISTRATION.