HomeMy Public PortalAbout2018.10.03 Manufactures Certificate of Origin for 2019 TrailmaxMANUFACTURER'S CERTIFICATE OF ORIGIN
Gem State Manufacturing, Inc.
MTOBER 3, 2018 'ffiV.th667
Kle j �-6 Ta01667 1ti'a9 IMILMAX
U I ILTIY�Y 4l'6l61�d"T
H, P: (S A E.) - 2$6b6 -LBS NO. CYLS 5 gPf2%-UT (4+16-) -
I, the undersigned authorized representative of the company, firm or corporation named below hereby certify
that the new vehicle ::described above is. the :property of the, said: company, firm;; or, corporation and is
transferred on the above 'date 'and under the Invoice Number indicated to the fdilowing distributor:or dealer.
NArvi OF DISTRIBUTOR, DEALER, ETC.`
CITY OF MCCALL
216 E PARK STREET
MCCALL, ID 83638:.`
It is further certified that this was the first transfer of such new vehicle in ordinary trade and commerce.
Gem State Manufacturing, Inc
t$IGNATURE OF AUTHORIZED REPRESENTA IVE) (AGENT)
GS0014994 Caldwell, �D983606
rY-STATE
Each undersigned seller certifies to the best of his knowledge, information and belief under penalty of law that the vehicle is new and has not been registered in
this or any state at the time of delivery and the vehicle is not subject to any security interests other than those disclosed herein and warrant title to the vehicle.
FOR VALUE RECEIVED I TRANSFER THE VEHICLE DESCRIBED ON THE FACE OF THIS CERTIFICATE TO:
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NAME OF
PURCHASER(S)
ADDRESS
I certify to the best of m knowledge that the odometer reading
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DEALER BY:
NAME OF DEALERSHIP DEALERS LICENSE NUMBER Being duly sworn upon oath says that the statements
set forth are true and correct. Subscribed and sworn
Stale of before me on this date
County of Notary Public
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION
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NAME OF
PURCHASER(S)
ADDRESS
I certify to the best of my knowledge that the odometer reading is No Tenths
DEALER BY:
NAME OF DEALERSHIP DEALERS LICENSE NUMBER Being duly sworn upon oath says that the statements
set forth are true and correct. Subscribed and sworn
State of before me on this date
County of Notary Public
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION
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NAME OF
PURCHASER(S)
ADDRESS
I certify to the best of my knowledge that the odometer reading is No Tenths
DEALER BY:
NAME OF DEALERSHIP DEALERS LICENSE NUMBER
duly sworn upon oath says that the statements
set forth are true and correct. Subscribed and sworn
State of before me on this date
County of: Notary Public
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION
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NAME OF
PURCHASER(S)
ADDRESS
I certify tothe best of my knowledge that the odometer reading is No Tenths
DEALER BY:
NAME OF DEALERSHIP DEALERS LICENSE NUMBER Being duly sworn upon oath says that the statements
set forth are true and correct. Subscribed and sworn
State of before me on this date
County of Notary Public
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION
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Federal Law requires you to state the odometer mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result
in fines and/or imprisonment.
I certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked. Odometer
Reading No Tenths. ❑ The mileage stated is in excess of its mechanical limits. ElThe odometer reading is not the actual mileage.
WARNING ODOMETER DISCREPANCY
Signature(s) of Seller(s)
Date of Statement Date of Sale
Printed Name(s) of Seller(s) Dealer's No Being duly sworn upon oath says that the statements
Signatures) of Purchasers) set forth are true and correct. Subscribed and sworn
before me on this date
Printed Name(s) of Purchaser(s) Notary Public
Company Name Of Applicable) State of
Address of Purchaser(s) County of
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION
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1st lien in favor of
whose address is
2nd lien in. favor of
whose address is