LETTER OF CONSIGNMENT
Owners Name
Date
Co-owners Name
Date
Address
Drivers License #
State
Telephone
VEHICLE INFORMATION
Year
Make
Model
VIN#
Mileage
Title #
State
Power of Attorney:
Color
( ) Actual
( ) Not Actual
( ) Exceeds Mechanical Limits
Type: Orig/Dup/Corrected
( ) Power of Attorney attached ( ) Title attached (not signed by owner)
( ) Photocopy of title attached (if the hold by lienholder)
LIENHOLDER(S)
Name___________________________________________________________________________________
Address_________________________________________________________________________________
( ) Letter of Consent for Sale from Lienholder(s):
Date Vehicle Received_____________________
attached
Driven in by____________________________________
TERMS OF AGREEMENT
Length:
From________________________________
Sale Price_________________________
To___________________________________
Commission______________________________(optional entry)
Comments________________________________________________________________________________
Dealer Name____________________________________________________
Number_________________
Dealer Address____________________________________________________________________________
Affirmation: We hereby certify that the information contained in this Letter of Consignment is true and correct
and that the ownership documents agree with a physical description of the vehicle and documents required by
Rule 1020.50 and IVC, sec. 6-305.1 are attached.
__________________________________________
(Dealer Signature)
Date
_____________________________________________
(Owner Signature)
Date