Certificate of Purchase - PDF

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                                                  Certificate of Purchase
                                               Transferring Ownership of Abandoned,                                            This space for use by
                                                                                                                                Secretary of State
                                                 Lost, Stolen or Unclaimed Vehicles
                                               Pursuant to Illinois Compiled Statutes
Secretary of State
Vehicle Services Department
501 S. Second St., Rm. 626                         This is not an Illinois Certificate of Title.
Springfield, IL 62756
                                                  This certificate must be completed in full.
217-782-6306
www.cyberdriveillinois.com


Vehicle Identification Number                                               Vehicle Make                                 Year Model

Body Type                    Color                    License Number                                  Year of Expiration                      State

Towed From                                            Towed To                                                 Authorized By

            This certifies that the above described abandoned or unclaimed vehicle was purchased by

                                                                     Name, Address

free and clear of any and all liens, being the highest bidder at public sale in accordance with 625 ILCS 5/3-117.1
and 5/4-208, on the                     day of                     A.D., 20 , Term of Said sale being as follows:

Total Purchase Price                 $
Towing Charges                       $
J Vehicle was not towed
Storage Charges                      $                           J          Days @ $                 per day
J Vehicle was not stored

Expenses of Sale                     $                           Specify

Subtract Total Cost of Sale          $
Net Proceeds of Sale                 $

The undersigned further certifies that after payment of all just expenses of sale and disposition of said vehicle, the net
proceeds of $           were delivered and paid over to                        , Treasury of                         , Illinois.

Note — With the proper junking or salvage application, a Junking Certificate or Salvage Certificate will be
issued from this Certificate of Purchase.

Name of Police Agency/Towing Firm

If Completed by Towing Firm, Towing Truck’s License Plate No.

Address
                                                                     Street, City, State, ZIP Code

X
                      Authorized Signature                                                                             Title

                                     Printed by authority of the State of Illinois. September 2007 — 60M — VSD 106.9