FOLDER CHECKLIST

YEAR : 02 MAKE : MODEL : 100607

LAST 6 OF VIN : 5
Toyota Camry Last Of

DATE ACQUIRED : ACQUIRED FROM :

O PROOF OF PURCHASE ACQUIRED MILEAGE :
O ODOMETER DISCLOSURE

QCASH
O FINANCED GPS :

PURCHASER'S NAME: Eric Delisle

CERTIFICATION OF POLLUTION DEVICES

ODOMETER DISCLOSURE AT SALE

MILEAGE AT SALE: Ebemos

PROOF OF INSURANCE
O BUYER'S GUIDE

TITLE BRANDED : YES / NO DISCLOSED TO PURCHASER : YES / NO

Lailaa.
DATE SOLD AT RETAIL:
DATE TITLE APPLIED FOR : 3322
WAS TRANSFER DONE IN 30 DAYS:

YES

O NO , WAS CUSTOMER CHARGED LATE FEE ? IF SO , EXPLAIN :

ESTIMATED TITLE AND REGISTRATION FEES : $ 88.50 The Only

ACTUAL TITLE AND REGISTRATION FEES : $ 7575

REFUNDJUNDERCHARGE: $ 12.75
 OUVIR WWW .
011575

850 N COURTENAY PKWY

63-1482/ 0670
MERRITT ISLAND , FL 32953
321-604-6716
RELIABLE AUTO SALES
RAS
DATE
319/22
$ 12.75
PAY TO THE Delisle
ORDER OF Eric Ecurity fitues
DOLLARS A wuded
Cat

Dollars anel 10/100

Jualue
TD BANK
NP

MEMO

— refund 437486 356

B1157511" 1:06 70148 2 21: ACY
CNTY # AGY # SUB # RPT # OFTHE
SEAL STATE L# 2539315
FO
T# 1615529141
19 2 HZI 5858 B # 1381103
STATE OF FLORIDA
AUDIT # NI TRUSS S # 90182756
GOD WE APPLICATION FOR VEHICLE/VESSEL
CERTIFICATE OF TITLE

TITLE NUMBER VEHICLE /VESSEL IDENTIFICATION # YR . MAKE MAKE or BODY VEHICLE COLOR WT/LENGTH GVW /LOC
MANUFACTURER TYPE

86062117 4T1BE32K320510067 2002 TOYT 4D SIL 3700

DATE OF ISSUE TRANS HULL VESSEL WATER FL NUMBER AUTH

VEHICLE USE PROPULSION FUEL TYPE DESTRUCTION
MO . DAY YEAR CODE MATERIAL

03 08 22 TRT PRIVATE
BIRTHDATE RESIDENT CNTY
SEX MO . DAY YEAR Y N ALIEN RES .#
Applicant /Owner's Name & Address
ERIC JOHN DELISLE M X 61
1 PEPPERCORN LN M 05 21 76 x
1st OWNER FL /DL # OR 2nd OWNER FL /DL # OR
PALM COAST, FL 32164-7461 F.E.I.D. # UNIT #

D424210761810

VOLUNTARY CONTRIBUTIONS
AGENCY TITLE FEE SALES TAX GRAND TOTAL
FEE

4.75 71.00 0.00 75.75

Action Requested : TRANSFER TITLE Brands :

RETAINED AS ELECTRONIC TITLE

PREV . STATE DATE ACQUIRED NEW USED ODOMETER / VESSEL MANUFACTURER ODOMETER
DECLARATION
CERTIFICATION
FL 02/21/2022 XX EXEMPT

DATE OF LIEN RECEIVED DATE FEID # OR FL / DL AND SEX AND DATE OF BIRTH DMV ACCOUNT #
LIEN INFORMATION

NAME OF FIRST LIENHOLDER :

SALVAGE TYPE
ADDRESS

SELLER INFORMATION
NAME OF SELLER , FLORIDA DEALER , OR OTHER PREVIOUS OWNER
RELIABLE AUTO SALES
ADDRESS
4657 S HWY 1 UNIT A
ROCKLEDGE, FL 32955
DEALER LICENSE NO
CONSUMER OR SALES TAX EXEMPTION #
VI11342481
INDICATE TOTAL PURCHASE PRICE , INCLUDING ANY $
SALES TAX AND USE REPORT UNPAID BALANCE DUE SELLER , BANK OR OTHERS
TRANSFER OF TITLE PURCHASER HOLDS VALID
EXEMPTION CERTIFICATE INDICATE SALES OR USE TAX DUE AS PROVIDED BY CHAPTER $ 0.00
IS EXEMPT FROM 212 , FLORIDA STATUTES
FLORIDA SALES OR VEHICLE / VESSEL WILL BE
USE TAX FOR THE USED EXCLUSIVELY FOR RENTAL
REASON ( S ) CHECKED OTHER SELLING PRICE VERIFIED

APPLICANT CERTIFICATION
IW/ E HEREBY CERTIFY THAT THE VEHICLE /VESSEL TO BE TITLED WILL NOT BE OPERATED UPON THE PUBLIC HIGHWAYS W / ATERWAYS OF THIS STATE .
I CERTIFY THAT THE CERTIFICATE OF TITLE IS LOST OR DESTROYED .
I CERTIFY THAT THIS MOTOR VEHICLENESSEL WAS REPOSSESSED UPON DEFAULT OF THE LIEN INSTRUMENT AND IS NOW IN MY POSSESSION .
IWE HEREBY CERTIFY THAT IWE LAWFULLY OWN THE ABOVE DESCRIBED VEHICLE /VESSEL , AND MAKE APPLICATION FOR TITLE . IF LIEN IS BEING RECORDED NOTICE IS HEREBY GIVEN THAT THERE IS AN
EXISTING WRITTEN LIEN INSTRUMENT INVOLVING THE VEHICLE /VESSEL DESCRIBED ABOVE AND HELD BY LIENHOLDER SHOWN ABOVE . I W / E FURTHER AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS .
UNDER PENALTIES OF PERJURY, 1 DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.

Signature of Applicant /Owner Signature of Applicant/Co -Owner

HSMV 82041 REVISED 02/06 SCAN CODE MVT

I UNDERSTAND THAT MY DRIVER LICENSE AND REGISTRATIONS WILL BE SUSPENDED IMMEDIATELY IF THE INSURER DENIES
THE INSURANCE INFORMATION SUBMITTED FOR THIS REGISTRATION .
3/2/22, 2:52 PM IMG_5587.jpeg

FLORIDA INSURANCE AFFIDAVIT

Under penalty of perjury , ! ERIC JOHN DELISLE cerlify that I have

(Name of insured )

Personal Injury Protection , Property Damage Liability , and , when

required , Bodily Injury Liability

Insurance currently in effect with GEICO under

(Name of Insurance Company )

4741124515 09170
(Policy Number) coveringthefollowingmotor vehicle :
Company CodeNumber(6digits )

2002 TOYOTA 4T1BE32K320510067

Year Make Vehicle identification Number

This insurance company is licensed to issue insurance policies in Florida. I understand thatmy
driver license , license plate (s ) and registration ( s ) will be suspended effective from the
registration
date , if the insurer denies that this policy is in force .

Signature of Insured

WARNING : GIVING FALSE INFORMATION IN ORDER TO OBTAIN A VEHICLE

REGISTRATION
CERTIFICATE IS A CRIMINAL OFFENSE UNDER FLORIDA LAW . ANYONE GIVING
FALSE INFORMATION ON THIS AFFIDAVIT IS SUBJECT TO PROSECUTION .

HSMV 83330( Rev. 09/09) www.flhsmv.gov

Delisle

Only
) will )
one
applicable )
one
Customer
circle 2024
SALES clrcle
Title Molto
AUTO A32955 please No ) No
UNIT when please one
AUTO ele.
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STOP HWY 1FL (

form . (
Year
, Ulle ( Yes Yes
RELIABLE ROCKLEDGE Plate please
authorization paper :
US Sunshine Eplrallon 2022 : Plate
Plale 2022
1ST 4657 New
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 FLORIDA INSURANCE AFFIDAVIT

Under penalty of perjury , I ERIC JOHN DELISLE certify that I have

( Name of Insured )

Personal Injury Protection, Property Damage Liability , and , when required , Bodily Injury Liability

Insurance currently in effect with GEICO under

( Name of Insurance Company )

4741124515 09170 covering the following motor vehicle :

( Policy Number ) Company Code Number ( 5 digits )

2002 TOYOTA 4T1BE32K320510067

Year Make Vehicle Identification Number

This insurance company is licensed to issue insurance policies in Florida . I understand thatmy
driver license , license plate (s ) and registration (s ) will be suspended effective from the registration
date , if the insurer denies that this policy is in force .

Eri Delich
Signature of Insured

WARNING : GIVING FALSE INFORMATION IN ORDER TO OBTAIN A VEHICLE REGISTRATION

CERTIFICATE IS A CRIMINAL OFFENSE UNDER FLORIDA LAW . ANYONE GIVING
FALSE INFORMATION ON THIS AFFIDAVIT IS SUBJECT TO PROSECUTION .

HSMV 83330 ( Rev. 09/09 ) www.flhsmv.gov

3/2/22, 2:52 PM IMG_5584.jpeg

FLORIDA INSURANCE AFFIDAVIT

Under penalty ofperjury , I ERIC JOHN DELISLE certify that I have

(Nameof Insured )

Personal Injury Protection , Property Damage Liability ,and , when required , Bodily Injury Liability

under
Insurance currently in effect with GEICO
(Name of Insurance Company )

4741124515 09170 covering the following motor vehicle :

(Policy Number) Company CodeNumber ( 5 digits )

TOYOTA 4T1BE32K320510067
2002
Year Make Vehicle identification Number

in Florida. I understand that my

This insurance companyis licensed toissue insurance policies
suspended effective from the registration
driver license, license plate (s ) and registration ( s ) will be
date if the insurer denies that this policy is in force .

Ein Delich
Signature of Insured

VEHICLE REGISTRATION
WARNING : GIVING FALSE INFORMATION IN ORDER TO OBTAIN A
ANYONE GIVING
CERTIFICATE IS A CRIMINAL OFFENSE UNDER FLORIDA LAW .
IS SUBJECT TO PROSECUTION .
FALSE INFORMATION ON THIS AFFIDAVIT

HSMV83330 (Rev. 09/09 ) www.flhsmy.gov

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3/2/22 , 2:52 PM
IMG_5583.jpeg

STATE OF FLORIDA
DEPARTMENT OP HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
Neil Kirken Building - Talialiassee, FL 32399-0500
MOTOR VEHICLE TITLE REASSIGNMENT SUPPLEMENT
Instructions on Reverse Side)
Tlits roussigoment is supplement 1a: I riue No B1010217 State of tasue: AL
Manolacturer's Statement or Certificate of Origin
is the alle electronic ? Yes X No
VEHICLE DESCRIPTION
Pabicle dentication Namber Year Make Model Body
TL5632 K3205 10067 2002 I tout
tout camry 4D
REASSIGNMENT INFORMATION
Nameof Seller Anne ISESTOR AUTO DU/ID3, DMS ACCT , FRIDA DEALERAUCTION LICENSE (if applicable )
RRULE AUTO SALES
4657 US WYSUNT A
SteelAddress 32085 vil/
State 34248 ||
Zip
City

Selling Price Or Applicable ) Sales Tax Collected (if Applicable) Sales Tax Reg . No. (If Applicable )
11 : 79 IS SOP 203SSI: 3
weer and Co-Purchaser's Priated Name(s ) Date of Sale
ERIC Delisle
i burchaser's Address City State 2/21/22

Peppercorn In Palm Coast

Co -Pur Address (if applicable ) City State 32164

Auction Name (If applicable ) Auction License Number State ofLicense DktorAuction

Sort Address City State

ODOMETER DISCLOSURE STATEMENT

WARNING : FEDERAL AND STATE LAW REQUIRE THAT YOU STATE THE ODOMETER MILEAGE IN CONNECTION WITH TRANSFER OF
OWNERSHIP FAILURE TO COMPLETE OR PROVIDING A FALSE STATEMENTMAY RESULT IN FINES AND /OR IMPRISONMENT.

DIOIT ODOMETER NOW READS, XX (NO TENTHS) MILES ,

VWE STATE THAT THISOsor Us CHENPP
DATE READ 2/2122 AND THEREBY CERTEFY THAT TO THE BEST OFMY KNOWLEDGE THE ODOMETER READING .
CAUTION 1. REFLECTS ACTUAL MILEAGE
READCAREFULLY 2 IS IN EXCESS OF ITS MECHANICAL LIMITS
BEFORE YOU 3. IS NOT THE ACTUAL MILEAGE WARNING ODOMETER DISCREPANCY
CHECK A BOX

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING

DOCUMENT AND THAT THE FACTS STATED INIT ARE TRUE .
Pred Nameofsellers een Soller Agent Signature

Lustin Ashness
Prated Nameof Co-seller ( if applicable ) mature (It applicable )

Puebasanosuture Co - Purchasone) Signature

Purchakeri i Narae First Full Middle Maderast Co-Purchaserts) Printed Nanna Birst, PolMiddle on Maiden Last

mike tudek (PA )

NOTICE. ANY ALTERATION ORERASURE MAY YOND THIS ASSIGNMENT AND ALCASSIGNMENTS THATFOLLOW

ORIGINAI.. SURMIT WITH APPLICATIOR PORTIILE COPY . SBLERDEAIERRETAININE

HSMV 82994 TRIV . 04/1408

1/1
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3/2/22 , 2:52 PM
IMG_5586.jpeg

STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTOR VEHICLES
2900 Apalachee Parkway Nell Kirkman Building - Tallahaesee, FL 32399-0620
Noticeof Sale of Motor Vehicle ,Mobile Home or Vessel
Section 319.222). Florida Statutes, requires that the seller file a Nodce of Sale with the
department
mobile bome, Filing this form removes any civil liability for the operation of the sold motor vehicle , within 30 days after the sale or uanset of motor vehicle or
real mobile home. In addition to
koop a copy or your bill of sale (we suggest it be notanzed ), certificate of tide or other typeof transaction you
belows , fear the top portion of this document at the perforation and mall to the address above or document showing due vehicle was complete the information
submit to your localtax collector's office or lemuse plate agency .
Ihave this day of transferred by assignment ofand delivered Florida Certificate of Tide to :
Name Purchaser(s ) Purchaser's DUID
First MI Last
Address
Selling Price $
UNDER PENALTIES OF PERJUAY , I DECLARE THAT I HAVE AEAD THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE
Seller's Signature Co - Seller's Signature
NOTE : THE SUBMISSION OFTHISFORM , ACCURATELY COMPLETED , TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCYOR TO THE
ADDRESS ABOVE WILL ALLOW THE TITLE CLERK TO UPDATE THEDMV DATABASE TOREFLECT THETITLE RECORDAS' SOLD " . HOWEVER ,
THE OWNERSHIP STATUS WILL NOT CHANGE UNTIL THE PURCHASER APPLES FOR AND IS ISSUED A CERTIFICATE OF TITLE.

AutoNatione
OUTRO : QAD
VE0008042 4181 S.W.8th Street 28-8012080297-21
Cotected
PENTER Seimer Miami, FL 33134
2 19
pero ayos $
MFSSAWOLO Add
DYACERE marami na SOA NUS Hang
SLIEMAT IHS101 .DATEREAD S.219 cocco
. AND LITERERT
|owTODONTER NOW PPADE DNI MN DO TENTLIS
CERTY ,MALES
THAT TO THEBESTOFMVKNOWLEDOKTHEODOMETER READING
REASYONDANT canREAD CAREFULLY ARETS ACTUAL MILEAGE 2 is in EXCESSOFMECHANICALLIMITS
ITS MKIMANICAL LIMITS 03. WARNING ACTUAL MILEAGE.
IS NOT THE ODOMETER DISCRHPANCY
MORE YOU EXCESSOFITS
CHECK A BON APPLJES TO S DIGIT ODOMETERS )
Purchase Me Co-Purchaser Must
SignHere : Sign Here
FIRST Prato Tyh Berly PrintHere
ORLANDO
Seram Auctiou Name When Applicablej. AUTO AUCTION
AUTONATION
She tutana
Per flere Hedy Carmona Auction License Number: VA - 11187481
Endless Auto , the Tax Tx
Selliay Dealer' s
|Baline Doala Name : 3804 N. US Hwy 1 No. Collected :
Diverse :
" V111947413 Vera Auto Saleo , u cocoa, FL . 32926 Date Solu :
Selling Dealer Ada 4657-USW 1 South leia /20
Purchaser AS Address :
Unit A
sadava WAVESTATE THATTHIS RockledgeFL- (NO TENTHS )MILESDATE READ 60 12 20 ANDI HERBAY
sD50 Dos 32965 ART UNITI CERTIFY THATTO THEBEST OF MY KNOWLEDGE TEEODOMETER READING
A REFLECTSACTUAL MILEAGE 2. IS IN EXCESS OFITS MECHANICAL LIMITS D 3 WARNING ACTUAL MILEAGE.
is NOT THE ODOMETER DISCREPANCY
CAUTION. READ CAREROLLY
BEFORE YOU
D (EXCESSOF ITS MECHANICALLIMITS
CHECK APPLIESTO S DIGIT ODOMETERS )
Co-Purchaser Music
Fundur Siga Bere:
SEIDNISNI Sale ratio Xincent
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Aution Near (When Applicables
ICNIC suất Aent Mua
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Tylu Buly Auction LicenseNumber
BH Tyler Beely Vera Auto Sales , the
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113282671 Selling Pales 4657 US Hwy 1 South .
bem 'vi
UnitA Dates :
ISTSTOPAUTO 4/20/21
Net Dator's Address: DARREDAKTE AUTO SALES Rockledge , FL 32955
AT
Per'sNak
ROCKLEDGE PL 32055 4 20.2.1 CAND 1 HEREBY
BROMPTE NO TENIS) MILES. DATE REAI,MYKNOW THE ODOMKIR RIADINI:
ODOMETER NOW READS CHxhY THAT TO THE BEST OP
VESTATETHATMUDDIN XTUAL HASAN
ITS MECHANICAL,MIS
IN EXCESS OFMIXCHANIGACLINETS is not a
READ CAREFULLY ROLECTS ACTUAL MILEAGE D 2. IS
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WANGDONSTER DISCREPANCY
CAUTON
KORE YOU APROPS 10 S DIOTTODOSIETERS
ECKA 103
Co-Purchase Me
Stan Here:
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3/2/22, 2:53 PM
IMG_5585.jpeg

UAB
, FL 322999500 ECO038
Mo LaSanteciton to : Dept of Highway Safety and Motor Vehicles, Ne Kalaman Duding Talinhas
Makedy WHP Vene Regis Number
lantation Number Year
FLORIDA 40 3700 BB082017 HEN
411BE32K3 2US 10067 2002 TOY
Date of Ismae 03/31/2018 W Reka
RegisteredOwe: Interest to descritvoi bereby released
JORGE LEONARDO OLIVA NEIL
3500 SN 12 AVENUE APT B219 Ta
MIANI FL 33166-3451 Onte
IMPORTANT INFORINTION is
1. When ownershipseller ofthe vehicle described herein
transferred , the full the
MUST completa inbottom
OF Transferol Thieby Seller sectionatthe of
the certificate of title
2. Upon sale of this vehicle , theseller must complete
Mind To the notice ofsale on the raverse side ofthis form ,
STATE vehicle
JORGE NARDO OLIVA 3 Removeyour licenseplate from the more information and
3500 SW 112 AVENUE APT 8210 4. See the web addrass below forfor to
the appropriate formsvehicle required the purchaser
MYAMY FL 33165-3451 title and registerthe , mobile home or vessel:
http://www.them govhtmiltlin html NOITCAFSITAS
.
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CERTIFICATE OF TITLE
Vessel Regis Ne The Number itten Release
Plooy WILD
86062117 Interestin the door de baruby
2002TOYS 3700
AT IBE32K320510087 Use Previssue Data by
Dry Brand Secondary Brand BIS
PRIVATE109 / 25 / 2017 TRI
Hus Material Prop Date of issue
Vessel Manufacturer or OHS Date
SEX 03/31/2018
EXEMRY
Roatared Own
JORGE LEONARDO OLIVA 8219
3500 SW 112 AVENUE APT
MIAMI FL 33165-3451

Ist Linholder

NONE

VEHICLES
FLORIDA DEPARTMENT OFHIGHWAY SAFETY AND NOTOR
TALLAHASSEE
DMSICH OF MOTORIST SERACES
Jan Clarke
Control Number 135047457 Terry L. Rhodes
Robot R Kynoch Executive Director
Roben A KIA
Deactor time of sale,)
section must be completed at the cannedien
TRANSFEROF TITLE BY SELLER ( This price and date moldin viathe lowester of ownership,
alle lege persoane, selling impot .
atthe seller fresudenalmuy result in lines or
Formidlo selow require
illo completa ur providingona the face ofthe contiene und be meanwhile bed is hereby iramidered to :
be free from my liene capepe noked 4181 SW BA SI Miami, FL 33134
Thiele iwanted to Addre
72-19
hondhet
CORAL GABLES multe altebructudine ha sidoneo
NationO.CHEVROLET 22:10 de
olan er besten Auto EXEMPTON LuxLinesiden bila,da bl. NITHE ACTUALMIERAGE
Die* odometar ouw raak
disi DINEXCESS OF TIS MECHANICAL LIMITS.
natld STATED IN IT ARE TRUE,
[ 1. ACTUAC MUBACE .
THE FOREGONG DOCUMENT AND THAT THE FACTS
THAT I HAVE READ
NORMALE OF PURJURY, I DECLARE -SELLER
Bien Hen
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ADVERBY LAW NOT POTTED FOR TRANESTER
NOTE

PIORIDA

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 BILL OF SALE /RETAIL INSTALLMENT CONTRACT
EXHIBIT: A

YEAR : 2002 MAKE : SALESMAN :

Toyota LAST 6 OF VIN: SIB 067
Oby Jack
CAMRY

NAME : Eric Delisle D.O.B.: 05-21-7le

CURRENT ADDRESS : EMAIL : o3@hotmail.com

de liste
PeppeR CORN LN .

Palm . Coast , FL. 32164_PHONE NUMBER :: (( 352)

) -
317 .0164

TAG STAUS ( CIRCLE ONE )

Title only
NEW TAG TURNED IN HAVE TAG NEED STICKER TAG TO TRANSFER :
TAG EXP DATE :
FULL SOCIAL :

DOWN PAYMENT: $ WEEKLY PAYMENT: $

***WEEKLY
PAYMENTS ARE SUBJECT TO LOAN APPROVAL ***

FINANCE CONSUMERS ONLY :

CURRENT EMPLOYMENT: PHONE NUMBER :

ADDRESS :

INFORMATION PROVIDED IS DEEMED RELIABLE THAT WAS PROVIDED BY CONSUMER . CUSTOMER AGREES ANY CHANGES
REQUIRED TO COMPLETE THE TITLE TRANSACTION WILL BE BILLED TO THE CONSUMER . UNTIL PAYMENT IS RENDERED FOR
OUTSTANDING BALANCE, CONSUMER HEREBY AGREES FOR COMPANY TO LIEN TITLE ON BEHALF OF OUTSTANDING
BALANCE

CONSUMER SIGNATURE : Elin Delisle DATE : 2-21-22

PRINT: Eric Delisle

 BILL OF SALE DATE : 2/21/2022 STOCK # : 10133
BUYER INFORMATION : SELLER INFORMATION :

FIRST STOP AUTO LLC

ERIC JOHN DELISLE
4657 US 1 UNIT A
1 PEPPERCORN LN
ROCKLEDGE , FL 32955
PALM COAST , FL 32164 COUNTY : FLAGLER
321-351-8444
HOME : CELL : 352-317-0194 WORK :
D.L./STATE ID #: D424210761810 STATE : FL EXP. DATE : 5/21/28
D.O.B .: 05/21/76 SALESPERSON : JACK
VEHICLE INFORMATION :
YEAR : 2002 COLOR 1 : SILVER VIN : 4T1BE32K320510067 STOCK : 10133
MAKE : TOYOTA COLOR 2 : STYLE : LE CYL : 4
MODEL : CAMRY BODY : 4DR MILEAGE : EXEMPT TRANS: AUTO
If this box is checked , the vehicle that you are purchasing has been licensed , registered, or used as a taxicab , police vehicle , or short - term - lease vehicle ,
is a vehicle that is rebuilt or assembled from parts, is a kit car , glider kit , replica, street rod , custom vehicle , has been repurchased by a manufacturer
under Florida's Lemon Law ( Fla . Stat . ch . 681 ) , or is a flood vehicle : ( indicate prior uses , brands or types )
TRADE - IN INFORMATION : SETTLEMENT
YEAR : COLOR :
MAKE : MILEAGE : VEHICLE PRICE 1,600.00
MODEL : BODY : 82.68
Predelivery Service Fee (see NOTE 1 ]
VIN :
SUBTOTAL 1,682.68
BALANCE OWED TO :
Sales Tax : 117.79
Title Fee : 88.50
BALANCE OWED : $ 0.00 GOOD THROUGH : License Fee : 0.00
ALLOWANCE : $ 0.00 QUOTED BY :
Registration Fee : 0.00
Transfer Fee : 0.00
INSURANCE INFORMATION :
Temp Tag Fee : 0.00
COMPANY: GEICO
AGENT :
PHONE : POLICY # : 4741124515 Payoff on Trade - in : N/ A
LIEN HOLDER INFORMATION :
COMPANY :
STREET:
CITY , STATE , ZIP :

REMARKS :

TOTAL DUE 1,888.97

NOTE 1: This charge represents costs and profit to the dealer for items such as inspecting, TRADE -IN ALLOWANCE N /A
cleaning, and adjusting vehicles, and preparing documents related to the sale . CREDIT
WARRANTY DISCLAIMER : DEPOSIT N /A
Unless Seller provides a written warranty , or enters into a service DOWN PAYMENT 1,888.97
contract within 90 days from the date of this contract, this vehicle is
being sold " AS IS - WITH ALL FAULTS " and Seller makes no warranties,
express or implied , on the vehicle , and there will be no implied TOTAL CREDIT 1,888.97
warranties of merchantability or of fitness for a particular purpose .
Cash O Finance BALANCE DUE 0.00
This disclaimer does not affect any warranties by the vehicle manufacturer. Seller
neither assumes nor authorizes any other person to assume for it any liability in it financed, please see your installment sales contract for information
connection with the sale of the vehicle and the related products and services. about finance charge, insurance , and terms of payment ( other than cash ).
CONTRACTUAL DISCLOSURE STATEMENT (USED VEHICLES ONLY) The information you see on the window form for this vehicle is part of this
contract. Information on the window form overrides any contrary provisions in the contract of sale . Spanish Translation : Guía para compradores
de vehículos usados . La informació n que ve en el formulario de la ventanilla para este vehículo forma parte del presente contrato . La informació n
del formulario de la ventanilla deja sin efecto toda disposició n en contrario contenida en el contrato de venta .
Buyer hereby declares that they are of legal age to transact business and that no unfair inducement has been made by Seller. This agreement
and the related documents that Buyer signs contemporaneously with this agreement, including any retail installment contract , contain the
entire agreement between Buyer and Seller and cancels and supersedes any prior agreement including oral agreements relating to the sale of
the motogvehicle. Any change to this agreement must be in writing and Seller must sign it .

Х 2/21/22 Х Eric Delish 2/21/22 х N /A

Accepted by Authorized Representative of Seller Date Buyer Date Co - Buyer Date
FZ -FL -BOS rev . 05/21 © 2021 Frazer Computing , LLC
 Vehicle Air Pollution Control Statement

Florida Law prohibits the operation , sale , lease , or transfer of title of any automobile or light-duty truck
( 1975 or newer , 10,000 pounds gross vehicle weight or less ) that has been tampered with . " Tampering"
means the dismantling, removal , or rendering ineffective of any air pollution control device or system
which has been installed on the vehicle by the vehicle manufacturer except to replace such device or
system with aa device or system equivalent in design and function to the part that was originally installed
on the motor vehicle (316.2935 , Florida Statutes ).

As a motor vehicle dealer licensed to conduct business in the State of Florida , I hereby certify that the
following air pollution emission control devices and system of this vehicle , if installed by the vehicle
manufacturer or importer, have not been tampered with by me or by my agents , employees, or other
representatives. I also hereby certify that I or persons under my supervision have inspected this motor
vehicle and , based on said inspection , have determined that the air pollution control devices and systems
listed below , if installed by the vehicle manufacturer or importer, are in place and appear properly
connected and undamaged as determined by visual observation .

This certification shall not be deemed or construed as a warranty that any air pollution control device or
system of the vehicle is in functional condition , nor does the execution or delivery of this certification
create by itself grounds for a cause of action between the parties to this transaction .

MAKE : MODEL : BODY TYPE :

TOYOTA CAMRY 4DR
VIN : YEAR :
4T1BE32K320510067 2002

Transferor's ( Seller's ) Signature :

☆
Transferor's ( Seller's ) Printed Name: FIRST STOP AUTO LLC

Transferor's ( Seller's ) Street Address : 4657 US 1 UNIT A

City : ROCKLEDGE State : FL Zip Code : 32955

Date of Statement: 02/21/2022

Transferee's ( Buyer's ) Signature: Eni Delile

Transferee's ( Buyer's ) Printed Name : ERIC JOHN DELISLE

Transferee's ( Buyer's ) Street Address : 1 PEPPERCORN LN

City: PALM COAST State: FL Zip Code : 32164

1975 - 1980 Model Year : 1981 or Newer Model Year

Catalytic Converter Catalytic Converter

Fuel Inlet Restrictor Fuel Inlet Restrictor
Unvented Fuel Cap Unvented Fuel Cap
Exhaust Gas Recirculation System ( EGR)
Air Pump and / or Air Injection System ( AIS )
Fuel Evaporative Emissions System ( EVP )
10133
Stock No.
Form approved by the Department of Environmental Protection

HSMV 84058 ( 06/10 )

 STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
www.flhsmv.gov/offices/

SEPARATE ODOMETER DISCLOSURE STATEMENT AND ACKNOWLEDGMENT

VEHICLE DESCRIPTION
Vehicle Identification Number Year Make Color Body Title Number

4T1BE32K32U510067 2002 TOYOTA SILVER 4DR 86062117

ODOMETER DISCLOSURE STATEMENT

WARNING : Federal and State law requires that you state the mileage in connection with an application for a
Certificate of Title . Failure to complete or providing a false statement may result in fines and /or imprisonment .

WE STATE THAT THIS O 5 or X 6 DIGIT ODOMETER NOWS READS EXEMPT .XX ( NO TENTHS ) MILES ,
DATE READ 02 21 1 2022 , AND WE HEREBY CERTIFY THAT TO THE BEST OF OUR KNOWLEDGE THE
ODOMETER READING :
1. REFLECTS ACTUAL MILEAGE .
CAUTION :
Read carefully before 2. IS IN EXCESS OF ITS MECHANICAL LIMITS (EXCESS OF ITS MECHANICAL LIMITS APPLIES TO 5 DIGIT ODOMETERS )
checking a box.
3. IS NOT THE ACTUAL MILEAGE . WARNING - ODOMETER DISCREPANCY

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE .

Seller's Signature Seller's Printed Name

Justin Ashness
Seller's Street Address

4657 US 1 UNIT A
City State Zip

ROCKLEDGE FL 32955

Buyer's Signature Buyer's Printed Name

Erie Delish Eric Delisle

Buyer'sStreet Address

1 PEPPERCORN LN
City State Zip

PALM COAST FL 32164

WHO IS AUTHORIZED TO COMPLETE THIS FORM ?

ANY PERSON WHO IS BUYING OR SELLING A MOTOR VEHICLE AND WHO MUST MAKE OR ACKNOWLEDGE AN ODOMETER
DISCLOSURE , IN ORDER TO COMPLY WITH STATE OR FEDERAL ODOMETER DISCLOSURE LAW .
WHEN SHOULD THIS FORM BE USED ?
1. WHEN A MOTOR VEHICLE , FOR WHICH AN ODOMETER DISCLOSURE IS REQUIRED , HAS BEEN SOLD .
2. WHEN A MOTOR VEHICLE , FOR WHICH AN ODOMETER DISCLOSURE IS REQUIRED , HAS BEEN PURCHASED .
3. WHEN AN ODOMETER DISCLOSURE STATEMENT AND ACKNOWLEDGMENT BETWEEN THE BUYER AND THE SELLER IS
REQUIRED , BUT NO ODOMETER DISCLOSURE STATEMENT HAS BEEN MADE ON ANOTHER STATE OR FEDERAL FORM .
WHEN SHOULD THIS FORM NOT BE USED ?
1. WHEN A FLORIDA TITLE WHICH WAS ISSUED ON OR AFTER APRIL 29 , 1990 IS AVAILABLE .
2. WHEN A FORM HSMV 82994 , MOTOR VEHICLE DEALER TITLE REASSIGNMENT SUPPLEMENT, HAS BEEN USED .
3. WHEN A FORM HSMV 82995 , MOTOR VEHICLE DEALER POWER OF ATTORNEY /ODOMETER DISCLOSURE , HAS BEEN USED .
4. WHEN AN OUT -OF - STATE TITLE , WHICH CONFORMS TO FEDERAL LAW , IS USED TO TRANSFER A MOTOR VEHICLE .
FILING :
1. COPIES SHOULD BE EXCHANGED BETWEEN THE SELLER AND THE BUYER . DEALERS MUST RETAIN THIS DOCUMENT IN THEIR
RECORDS FOR A PERIOD OF FIVE YEARS .
2. IT IS NOT NECESSARY TO FILE THIS FORM OR ANY COPY OF THIS FORM WITH THE STATE OF FLORIDA, UNLESS REQUESTED TO
DO SO BY THE DIVISION OF MOTOR VEHICLES .

Check your local phone book government pages or visit the following website for current mailing addresses : http://www.flhsmv.gov/offices/

HSMV 82993 ( REV. 11/11 )

 ARBITRATION AGREEMENT

This Arbitration Agreement (“Agreement") significantly affects your rights in any dispute with us . Please read
this Agreement carefully before you sign it . This Agreement is governed by the Federal Arbitration Act , 9
U.S.C. S $ 1 et seq .

In this Agreement , “ you ” and “ your” refer to the buyer signing below . “We ," " us ," and “ our ” mean the Seller , our
employees , agents , successors or assigns . “ Dispute " means any disagreement in contract , tort, statutory or
other claim or dispute between you and us arising out of or relating to your credit application , any retail
installment sales contract or any resulting transaction or relationship . “ Dispute” includes any claim or dispute
over the interpretation and scope of this Agreement.

EITHER YOU OR WE MAY CHOOSE TO HAVE ANY DISPUTE BETWEEN US DECIDED BY

ARBITRATION AND NOT IN COURT . IF A DISPUTE IS ARBITRATED , YOU WILL GIVE UP YOUR RIGHT
TO PARTICIPATE AS A CLASS REPRESENTATIVE OR CLASS MEMBER ON ANY CLASS CLAIM YOU
MAY HAVE AGAINST US . ANY DISPUTE IS TO BE ARBITRATED ON AN INDIVIDUAL BASIS AND NOT
AS A CLASS ACTION . YOU EXPRESSLY WAIVE ANY RIGHT YOU MAY HAVE TO ARBITRATE A
CLASS ACTION . THIS IS CALLED THE " CLASS ACTION WAIVER .”1

Arbitration will be conducted by and under the rules of the American Arbitration Association (AAA )
( www.adr.org ), or any other arbitration organization you choose , subject to our approval. You may obtain AAA
rules by visiting the website .

Arbitrators will be attorneys or retired judges and must be selected pursuant to the applicable rules of the
chosen arbitration organization . The arbitrator shall apply governing substantive law and the applicable
statute of limitations . The arbitration hearing must be conducted in the federal district in which you reside , or
at some other location convenient to you . We will pay your filing, administration , service or case management
fee and any arbitrator or hearing fee all up to a maximum of $ 2,500 , unless applicable law or the rules of the
chosen arbitration organization require us to pay more . Each party will be responsible for its own attorney ,
expert and other fees , unless otherwise awarded by the arbitrator under applicable law .

You retain the right to sue on an individual basis in small claims court for a Dispute within that court's
jurisdiction , unless such action is transferred , removed or appealed to a different court. Neither you nor we
waive the right to arbitrate by filing suit . We do not waive our right to arbitrate by seeking non - judicial recovery
of a vehicle .

The arbitrator's award is final and binding on all parties, subject to any right of appeal available under the
Federal Arbitration Act. Any court within jurisdiction may enter judgment on the arbitrator's award . This
Agreement shall survive any termination , payoff or assignment of the retail installment contract . If any part of
this Agreement , other than the class action waiver , is deemed or found to be unenforceable for any reason ,
the remainder is enforceable . If the class action waiver is deemed or found to be unenforceable , then this
entire Agreement will be unenforceable .

This Agreement is incorporated into and becomes a part of any retail installment contract or other credit
obligation that we enter into with you on the date you sign this Agreement .

You may opt out of this Arbitration Agreement by doing so in writing to the address shown below and
sent by registered mail , postmarked no later than 10 days from the date you sign this Agreement .

Х Eric 2/21/2022
Delish
Buyer : ERIC JOHN DELISLE Date

Seller : FIRST STOP AUTO LLC By :

Seller's Address : 4657 US 1 UNIT A ROCKLEDGE , FL 32955

f
Z
FZ -ARBITRATION 04/20 © 2020 Frazer Computing , LLC
 Here is a list of some major defects that may occur in used vehicles .

Frame & Body Cooling System Steering System

Frame -cracks, corrective welds, or rusted Leakage including radiator Too much free play at steering wheel
through Improperly functioning water pump ( DOT specs .)
Dog tracks----bent or twisted frame Electrical System Free play in linkage more than 74 inch
Engine Battery leakage Steering gear binds or jams
Oil leakage, excluding normal seepage Improperly functioning alternator, generator, Front wheels aligned improperly
Cracked block or head battery, or starter ( DOT specs.)
Belts missing or inoperable Fuel System Power unit belts cracked or slipping
Knocks or misses related to camshaft Power unit fluid level improper
Visible leakage
lifters and push rods Suspension System
Abnormal exhaust discharge Inoperable Accessories
Gauges or warning devices Ball joint seals damaged
Transmission & Drive Shaft Air conditioner Structural parts bent or damaged
Improper fluid level or leakage , excluding Heater & Defroster Stabilizer bar disconnected
normal seepage Spring broken
Cracked or damaged case which is visible Brake System Shock absorber mounting loose
Abnormal noise or vibration caused by faulty Failure warning light broken Rubber bushings damaged or missing
transmission or drive shaft Pedal not firm under pressure ( DOT spec. ) Radius rod damaged or missing
Improper shifting or functioning in any gear Not enough pedal reserve ( DOT spec . ) Shock absorber leaking or functioning
Manual clutch slips or chatters Does not stop vehicle in straight line improperly
Differential ( DOT spec . ) Tires
Hoses damaged
Improper fluid level or leakage , excluding Drum or rotor too thin (Mfgr Specs ) Tread depth less than 2/32 inch
normal seepage Sizes mismatched
Lining or pad thickness less than 1/32 inch
Cracked or damaged housing which is Power unit not operating or leaking Visible damage
visible Structural or mechanical parts damaged Wheels
Abnormal noise or vibration caused by faulty Visible cracks , damage or repairs
differential Air Bags
Mounting bolts loose or missing
Exhaust System
Leakage
Catalytic Converter

DEALER NAME
FIRST STOP AUTO LLC
ADDRESS

4657 US 1 UNIT A ; ROCKLEDGE , FL 32955

TELEPHONE EMAIL
321-351-8444
FOR COMPLAINTS AFTER SALE , CONTACT:
Add name here : M - 1-9

I hereby acknowledge receipt of the Buyers Guide at the closing of this sale .

2-21-22
Erin Delisle
Signature Date

IMPORTANT: The information on this form is part of any contract to buy this vehicle . Removing this label before
consumer purchase (except for purpose of test- driving ) violates federal law ( 16 C.F.R. 455 ) .
 Vehicle Information Check

Vehicle Information :
Vehicle Identification Number : 4T1BE32K320510067 2002 TOYOTA
Year / Make:
Previous Title State : FLORIDA Registration Expiration Date :
Title : 86062117 Title Issue Date : 3/31/2018
Title Status: SOLD Title Print Date :
Odometer Reading / Status : EXEMPT Odometer Date :
Color: ALUMINUM / SILVER Vehicle Type : AUTO
Net Weight : 3,700 Owner Information : 1 owner
Paper Title Salvage :
Brands :

Lien Information
There is no lien on this vehicle .

If any of the information on this record needs to be corrected , please contact

your tax
collector and complete appropriate paperwork to update the record .
If you have lost or misplaced your title and need to apply for a duplicate , click here for the
form and instructions .
 USA

Florida DRIVER LICENSE

9CLASS E
1001D424-210-76-181-0

DELISLE
»ERIC JOHN
1 PEPPERCORN LN
PALMCOAST, FL 32164-7461

spog 05/21/1976 1556x M

ab exo 05/21/2028 16HOT 5 '-08 ***
12 REST NONE 9a END A

SAFE DRIVER

1a ( 9 05/08/2020

50D H862012110064
AT REPLACED 12/11/2020
Oparatton of a motor velocle consututas
consent to any sobrety est required by law.
gru
 AUTHORIZATION FOR CREDIT CARD USE

PRINT AND COMPLETE THIS AUTHORIZATION AND RETURN

ALL INFORMATION WILL REMAIN CONFIDENTIAL

NAME ON
CARD :
Eric J. Delisle
BILLING
ADDRESS :
RN
1 Peppercorn W

Palm Coast , FL. 32164

CC TYPE : VISA MASTERCARD AMERICAN

DISCOVER
EXPRESS

CARD NUMBER :
4744 7601 9192 9175

EXPIRATION :
05/23

CVV : 311 ( 3 DIGITS LOCATED ON BACK OF CARD )

AMOUNT TO
CHARGE : $ 97
s ( USD )

I AUTHORIZE EMPIRE MOTORS, LLC TO CHARGE THE AMOUNT LISTED ABOVE TO THE CREDIT CARD
PROVIDED HEREIN . I AGREE TO PAY FOR THIS PURCHASE IN ACCORDANCE WITH THE ISSUING BANK
CARDHOLDER AGREEMENT. I UNDERSTAND A 3 % CONVENIENCE FEE WILL BE APPLIED TO ALL CHARGES .

CARDHOLDER- PLEASE SIGN AND DATE

SIGNATURE : Delale DATE : 2-21-22

Eric

PRINT NAME : Eric Delisle

***
**ALL SALES ARE FINAL - NO REFUNDS OR EXCHANGES ***

EMPIRE MOTORS , LLC

ACCESS FINANCIAL GROUP INC

321-351-8444
Receipt

Transaction Information

Transaction ID : 089tpfc61r8v5r2f16ko
Merchant : Reliable Auto Sales
Merchant Website :

Merchant Phone : 3214009964

Transaction Date : 02/21/2022 13:41:01 EST

Transaction Type : Sale
Subtotal : $ 88.97
Tax : $ 0.00

Shipping : $ 0.00
Service Fee : $ 0.00
Discount : $ 0.00

Amount Authorized : $ 88.97

Amount Captured : $ 88.97

Base Amount : $ 88.97

Total : $ 88.97
PO Number :

Order ID :

Authorization Code : 114815

Response : approved

Payment Information

Cardholder Name :

Card Type : Visa

Payment Type : card
Account # ** ********* 9175 05/23
 Bill of Sale

Buyer Seller

FIRST STOP AUTO LLC VERA AUTO SALES

4657 US 1 UNIT A 4657 US HWY 1 SOUTH UNIT A

ROCKLEDGE , FL 32955 ROCKLEDGE , FL 32955

321-351-8444

Sale Date : 2/21/22

Year : 2002

Make : TOYOTA

Model : CAMRY

Color : SILVER

VIN : 4T1BE32K320510067

Mileage : 149,000

Total Price : 0.00

Odometer Disclosure Statement

Federal law ( and state law , if applicable ) requires that you state the mileage upon transfer of ownership .
Failure to complete or providing a false statement may result in fines and/or imprisonment.

I , VERA AUTO SALES , state that the odometer now reads

EXEMPT miles and to the best of my knowledge that it reflects the actual mileage
of the vehicle described above, unless one of the following statements has been checked

[ ] ( 1 ) I hereby certify that to the best of my knowledge the odometer reading

reflects the amount of mileage in excess of its mechanical limits .

[ ] ( 2 ) I hereby certify that the odometer reading is NOT the actual mileage .
WARNING : ODOMETER DISCREPANCY .

Date : 2/21/22
Buyer Signature :

In

Date : 2/21/22
Seller Signature :
Meille