I, the owner______________________________
whose address is _________________________
do hereby sell to___________________________
one 19_________ (make)________ (Ident #)______
for the sum of___________ (sales price is optional).
I, the owner, hereby affirm that there are no outstanding liens against the above described vehicle, that I have the legal right to sell such vehicle, and that the certificate of title has been either (check one):
[] Lost or destroyed, OR
[] Marked "JUNKED" and surrendered to the Department of Transportation.
Owner's identity verified by either:
Driver's license #__________________
Credit card #_________ with_________ company.
Owner (seller) Signature_______________
date_________
Purchaser Signature____________
date_________
Wis. Admin. Code Department of Transportation Trans 136.02