HomeMy WebLinkAboutFlorida Department of Highway Safety & Motor Vehicles-1982 05 03
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CITY OF WINTER SPRINGS, FLORIDA
400 NORTH EDGEMON AVENUE
WINTER SPRINGS, FLORIDA 32708
Telephone (305) 327-1800
Hay 3, 1982
Dept. of Highway Safety & Motor Vehicles
Division of Motor Vehicles
1072 W. Gaines Street
Tallahassee, Fl. 32304
Dear Sirs:
Enclosed please find application for Certificate of Title,
Manufacturer's Statement of Origin, Certificate of Motor
Vehicle Sales Tax Exemption and City check in the amount of
$10.85 for City tag and title for the new fire truck for the
City of Winter Springs.
If there is any further information you may need, please
let me know.
Yours truly,
CITY OF WINTER SPRINGS
'" .-CJ.-r---
,/YL4-tJ1' I ' /lrt/....'H../
Mary T. Norton,
City Clerk
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TITLE NUi\lBER
APPLICA TION FOH CERTIFIC\ TE OF'"TITLE
A:\D/OR YEHlCLE REGISTRATION
STA TE OF FLORIDA
Owner's :'\alllt".
Sex & DOB
Tax Stamp
I. CITY OF WINTER SPRINGS
Addrc-'..
DL7!
2400 N. EDGEMON AVE.
DL7!
City or Town
(Zip)
3. WINTER SPRINGS.~L.32708
Audit State Prevo Registered
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Ht'rdl\ "t,ltcs th,tt ht>, she, Of it is tht> lawful owner of tht:' following .J
de:<inifwd llIotor vehicle <.l!ld makes applicJtion for (CHEC~ ONE) 0
~~::~~E~~'rEEG~~";~~~~N ~ o~ BOTH ~
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Date Graded by Transaction Code
4.
BHP WEIGHT
CLASS CODE G\'W
\\\!-:E
TYPE
WHITE
\IODEL
5 RX2-64
IDE:\TIFICATIO:\ :-':0.
19_
FLORIDA TAG 1\0.
ST"'TE PREVo REGISTERED
62/23/82
7. Abo\"t' descrihed vt'hide acquired hy PURCHASE (purchase. gift. traue. inheritalH.'e. ete,)
from GRUMMAN EMERG.PROD. ,INC. ,ROAL'lOKE,VA.24012
(Name) (Address) (Zip)
Applil'ation will not be <.\l.;(,:epted ulllt:'ss the following lien statements are completed.
I/\\'e t.:t"rtify that all liens on thb vehicle Me listed below.
LlE:\ HOLDER LIE:\S .---- ....
8. If no lien write "~one" above
STREET ....DDRESS
DATE OF LIE;\;
9.
CITY A:\D ST.....TE
(Zip)
A~IOUlXT OF LIE"
10.
THIS VEHICLE WILL 0 WILL ;\;OT 0 BE USED FOR HIRE
E WILL BE US TA:GCAB 0 V-DRIVE-IT 0 LO:\G-TER~I LEASE 0 POLICE CAR
By
(Signature of Person Signing for Applicant)
SIG~ATCRE .
OFI \
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By
CI MANAGER (Signature of Persons Signing for Applicant)
~ubscrib{'d,and ,s'WPJf to before me at IA. ~(.,-:",!A' 4.N~ . . '
In the Stat~ of .e,1fc~1 ~t ~, Tbls ~~!::.... N ~ of . ~~ ' 19G-
, I \ Notary Public ~. .1?~~bIlC_ S~'" "f ng;:jd-J at L ~..
Y ( .. ilril~
(SEAL) , ' Date Commission expires . ommlS)fon .,,,; ~: .
'DEALER'S CERTIFICATE AND TRA" mn fire a C.'ualty C;mpany
1 hereby certify that the motor \"f"h~ descrihed above is a ne\\-'ked 0 vehicle and was acquired b~' me from
G'"JCdA!1P'1J!.!.~12LtVfIt.,.f:..DN..~~~~c. .
11~.3 .::;:41 S~ D.cr.' (\bnufaclurer. Distrib7 or Former Owner)
R.e;.AN~~C.J P4 .a,,49,/:z.. and hereby transfer all my rights, title and
(Address)
interest in tbe said vehicle toC1" ,JII: uA$"~...J;AL~ ,IdAd~~.s;~,.,~
(Dealer or Purchaser) (Address)
I hereby ~'3rra.nt title to t.he said vehicle and certify there are no existing liens ex<..'ept as shown in this applieation, 1 further certify that the
sales tax Imposed hy Chapter 212, Florida Statutes, upon this vehicle has been paid hy the purchaser thereof.
Amount Sales Tax Collected S h/A Sales Tax Reg. No /VIA
D~aZnL;dz~~.~...z,~. .
BYt 0 ;~,.. D"le, Lie.n,. No l< 3).. rr - (, 1 'I
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ii CITY OF WINTER SPRINGS
II GENERAL FUND
:1 PlI. 305-327-1800
!i 400 NOaTI! :E;DGE~ION AVENUE
II
1.1 WINTER SPRINGS. FLORID.A. 32708
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TAOPJC BANK@
OF SE MINOl.e
Casselberry, Florida 32707
Winter .Sprin.;J~ Office
May 5
19 82
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'I PAY
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W:~~2R3'},~1~I () DOtS 1~31 c)
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Dept. of Highway Safety & Motor Vehicles
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'I 11'001,0 I, 'ill' .,:O!; 3 ~OB 3 ~BI: 0 2 ~ 50000!; 1,11'
!t;~~.__.._ _ .. _ _______._________.______.____ ___.___. _________
~~(.~;.;;.=-;;--~- --- _._--~ -~':" '-::":,,,-,,- . -::...........- -------:..-..~~-_.- ,. :..:_:.:::........... .--- ::..::::.:..:.:.~:~..._------.:...:~:..:.::..:.::::.-:.__::.::..:. _.~~ ----..---.:::-:.:.;.
OE ~u>(~ CMi:C.... PHINTEHS
TO
THE
ORDER
OF
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.......... . "..,
----.. ~---_._._---
__n_____.__.___ _
....... ,...
CITY Of" WINTER SPRINGS
GENERAL f"UND
DETACH AND RETAIN THIS STATEMENT
THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW,
IF NOT CORRECT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DESIRED.
DELUXE - f"ORM WVC-2 V-2
4049
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DATE
DESCRIPTION
AMOUNT
May 5, 1982
City tag and title for new fire truck
28-52.3
10.85
V-2
DR-41.A
Rev.4-1-7t;
NOTE: Purchasers holding. Certificate of Exemption, such as state agencies, counties, etc., or when
vehicle is used for rental exclusively should use this form. The purchase of motor vehicles to be offered
for rent as living accommodations does not qualify for exemption.
CERTIFICATE OF MOTOR VEHICLE SALES TAX EXEMPTION
Date~r ~.~ /~-&.
I certify the motor vehicle described below has been purchased by:
Check One
----^- person holding sales tax certificate of exemption.
----^- business for use exclusively for rental purposes.
and is exempted from the sales tax imposed by chapter 212, Florida Statutes.
WHITE
1982
'l'n'e
Year
~Iake
1WXDCHUF1CN052049
RX2-64
Mollel
Engine or J.D. Xumber
Grumman Emergency Products, Inc.
1723 Seibel Dr.,N.E.
Ronnokc,V3.21012
AIIII reRg
~ame of Seller
1.
CITY OF WINTER SPRINGS
By
GR.
Agene~' or Or/:alli7.ntion
400 N.EDGEMON AVE.
Allllress WINTER SPRINGS ,FL. 32708
04-00195-00-69
Certifiea te of Exemption Xo.
2. This space to be completed by purchaser of vehicle to be used for rental purposes:
NOTE: The purchase of motor vehicles to be offered for rent as living accommodations does not qualify
for exemption.
Sales Tax Registration Xo.
"E" Tag No.
By
Firm Xame
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