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HEARNAP — Part 41
Page 101
101 / 365
Boe a UR EEN
ements
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Identification ew DD DbODL SLL 0 Plote Moke. S.
Engine No
Now Bears 1927 steam number / K ‘4 Li 3 State of Z iP ws ihe i
Does Vehicle Identification Number Appear Yo Hove Bean Altered of Tampered With? (] Tye
5 Ve
Reema eh the description
| certify 1 have physically examined the hicle described above and | find the descriptio
af the vehicle t indi a Seb . 1¢ ;
BIQMATEEE O VERIFIGR TITKE O8 ia ne, oaTs H
County.
REGISTRATION QUESTIONNAIRE
the applicant signing this application certifies to the truth and correctness of the infarmation given.” :
Registration Information Le :
1. this vehicle entered California on - - + * Month. £
Are you a resident of California? - © - + * *
lf “Yes when did you become o resident? . montnilip Me—®
Are you goinfully amployed or In business in California? # . > -
If "Yas when did you become gainfully employed
or enter into business In Colifornio? «© se
Will this vehicle be used to transpart persons for hire?
Will this vehicle be used to transport property for hire?
| Ih vehicle ts to be used for hire, ;
compensation, or profit, give P.ULC. nw number - > > S .-
This vehicle wos fast lcensed in < ii
aATATE Of COUNTET
When this vehicle wos lost lleansed you ware a resident Zé a eS
STATE OG COURTEF
Except for any accompanying titles, are there any autstonding
titles for this vehicle isved by any stote or country? - 6 6 st tt Ys O
ta this vehicle now belng used os security for any lien other then the {len
shown {i any) on the reverse side of this opplicottion? ©. 5 7 Ys Cl No
Ure Tax and Vehicle itconse Fee imtormetion
This vehicle was purchoted from a Dealer YY hie
Manufacturer []. Individvel Clon... . Mo
Delivery of this vehicle wos taken on» se Ct Monn
_ The purchase price (selling price) of this vehicle wos :
ide not Include sales tax, Insurance or finance charges) - «+ 3 L200 Le
Note: The total cost of the vehicle must include the coxt of the basic vehicle and all accessories,
attachments, machinery, eatro equipment, leased equipment, mechanical equipment and
electr equipment permanently attached in of n the chassis, motor of body.
Are you on active duty ot @ member of the U.S. Armed forces? - - -
If “Yea and you are not a residant of Colifornio, ask for end complete
Department form Reg. 344,
When this vehicle was last lleansed, ware you on active duty as ,
member of the U.S. Armed Forces? «2 se es ttt “4 .
5 Yes’ the Tate or country where you were stationed ,
. a :
A vahicl dealer ragistering this vehicle in the nome, af bi deatership need answet only
quations 1, 4 6.7, 9, 19 and 13 ty
; . . ° G i ia 1 mom © JZ one
ce ee ee ee meme ee neces ge ea
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