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Illinois Junk Vehicle Bill of Sale


Illinois Junk Vehicle Bill of Sale
Illinois Junk Vehicle Bill of Sale
Secretary of State
Junk Vehicle Bill of Sale
Secretary of State
Vehicle Services Department
501 S. Second St.
Springfield, IL 62756
217-782-6306
www.cyberdriveillinois.com
This is not an Illinois Certificate of Title.
This certificate must be completed in full.
This space for use by
Secretary of State
I, current Illinois owner ________________________________________________________________________________ ,
whose address is ______________________________________________________________________________________
City ________________________________________________________________ Illinois ZIP Code _______________ ,
does hereby sell/give to ____________________________________________________________________________________
a Year __________________________ Make ___________________________ Model ___________________________
Vehicle Identification Number ______________________________________________ for the sum of $ _______________ .
I, current Illinois owner, do hereby affirm that there are no outstanding liens against the above described vehicle, that I have
legal right to sell/give such vehicle and that the Certificate of Title has been lost.
Current Illinois Owner Signature __________________________________________________________________________
Purchaser Signature ____________________________________________________________________________________
Date______________________________________________________________________________________________
Note: This form is only to be used with a Certificate of Final Disposition and only a Junking Certificate will be issued.
Printed by authority of the State of Illinois. May 2005 — 3500 — VSD 658
Illinois Junk Vehicle Bill of Sale