Transcription of Wisconsin Surplus Online Auction
1 Wisconsin Surplus Online Auction Wisconsin Used Car Dealer, License # 3887. PO Box 113, Mount Horeb, WI 53572 0113. (608) 437-2001 / Fax (608) 437-9593 vehicle BUYERS' REQUIRED INFORMATION: Please complete the following information! This information is required in order to complete the purchase of your vehicle ! NOTE: this information will be used for title & license plate application purposes only!! vehicle #:_____ Bidder #:_____. Anticipated Pick-up Date & Time: _____. Owner(s) Full Name: _____. (Be sure to list all owners for the TITLE, if more than one use and/or separator!!). Complete Mailing Address: _____. City: _____ State: _____ Zip: _____. # 1 Owner's Driver's License or SSN # _____. # 2 Owner's Driver's License or SSN # _____. # 3 If Titled in a Company Name FEIN # _____. Owner's Telephone #: _____ Cell# _____.
2 Date of Birth(s): _____. Do You Have Current Wisconsin License Plates to Transfer to This vehicle : Yes / No (Transfer plate must be in your name or your spouse's name only!). If YES, Please list the EXACT license plate number to transfer: _____. vehicle Will Be Kept In the COUNTY OF: _____. vehicle Will Be Kept In the City/Village/Town of: _____. License Plate Information: Popular Wisconsin Plate Types: 1) $75 Automobile (Cars, Vans, SUVs) 6) $209 12,000# Truck 2) $75 4500# Truck 7) $ 10,000# Trailer 3) $84 6000# Truck 8) $ 12,000# Trailer 4) $106 8000# Truck 9) $283 16,000# Trailer 5) $155 10,000# Truck 10) $45 Farm Truck up to 12,000#. Desired Wisconsin License Plate Type: _____. Lender Information: Lenders Name:_____. Lender Contact:_____Phone:_____. Lenders Lien Number:_____. I, the above listed buyer, fully understand that I am buying this vehicle AS IS with no warranties of any type, and accept the vehicle accordingly, WITHOUT a test drive, and subject to no returns, representations, or warranties, of any type.
3 I further understand that the purchase price was arrived at via my public Auction bidding, plus applicable buyers' fees. Further, I hereby authorize Wisconsin Surplus Online Auction /Lust Auction Services, LLC and their staff to act as my agents for processing all required sales & titling forms and related paper work relative to this purchase, using the above provided personal information: Buyer's Signature: _____Date:_____.
