Canada MOTOR VEHICLE BILL OF SALE (Please type or print in BLOCK LETTERS) BLOCKS “A” AND “B” MUST BE COMPLETED TO RENDER THIS BILL OF SALE ACCEPTABLE FOR VEHICLE REGISTRATION. BLOCK “C” IS OPTIONAL A THIS IS TO CERTIFY THAT I, THE SELLER NAME Surname Given name(s) PHONE NO. ADDRESS Number & Street City/Town Province/Territory Postal Code PERSONAL IDENTIFICATION - NUMBER TYPE – (eg OPERATOR’S LICENCE) l DO HEREBY SELL MY VEHICLE DESCRIBED AS FOLLOWS MANUFACTURER YEAR MAKE MODEL PLATE NO. ODOMETER READING SERIAL NUMBER (VIN) VEHICLE BODY COLOR VEHICLE ROOF COLOR TYPE OF VEHICLE – ENTER “X” OFF-HIGHWAY VEHICLES ____ 2 DOOR SEDAN ____ MOTORHOME ____ FARM TRACTOR ____ ALL-TERRAIN VEHICLE ____ 4 DOOR SEDAN ____ UTILITY VEHICLE ____ HEARSE ____ MINI-AUTO ____ CONVERTIBLE ____ MOPED ____ SERVICE RIG ____ MINI-BIKE (2 WHEELS) ____ HATCHBACK ____ MOTORCYCLE ____ TRUCK ____ MOTORCYCLE ____ SPORTSCAR ____ AMBULANCE ____ TRUCK/TRAILER ____ SNOW VEHICLE COMBINATION ____ STATIONWAGON ____ BUS ____ VAN _____ SCHOOL BUS TRAILERS - _____ PUBLIC SERVICE/COMMERCIAL ____ UTILITY (PERSONAL USE) ____ BOAT ____ TENT TO THE FOLLOWING BUYER: NAME Surname Given Name(s) PHONE NO. ADDRESS VEHICLE SOLD FOR SUM OF - $ (SUBJECT TO THE TERMS & CONDITIONS SPECIFIED IN BLOCK “C”, IF ANY) l $ B I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE DATED THIS ___________________ DAY OF ___________________, 20___ TO THE BEST OF MY KNOWLEDGE AND UNDERSTANDING AT _____________________________________________________________ _____________________________________________________ SELLER IN THE PROVINCE/TERRITORY OF __________________________________ _____________________________________________________ SELLER'S WITNESS IN THE COUNTRY OF _____________________________________________ _____________________________________________________ BUYER ____________________________________________________ BUYER’S WITNESS C (OPTIONAL) SPECIAL CONDITIONS OF SALE – THE VEHICLE DESCRIBED ABOVE IS 1. FREE OF ALL LIENS AND ENCUMBRANCES? YES NO IF NO, NAME OF LIEN HOLDER IS __________________________________________________________________________________________ MONEY OTHER 2. PAID IN FULL? YES NO PAID BY CASH CHEQUE ORDER (SPECIFY)____________________________ 3. PAYMENT TERMS? YES NO IF YES, SPECIFY _____________________________________________________________________ 4. WHERE WAS VEHICLE LAST REGISTERED? __________________________________________________________________________________ 5. SPECIAL CONDITIONS OF SALE? YES NO IF YES, SPECIFY _________________________________________________________ ____ OTHER VEHICLE - DESCRIBE INFORMATION FOR A BUYER/SELLER OF A MOTOR VEHICLE 1. THIS BILL OF SALE FORM, PROPERLY COMPLETED (OR A DOCUMENT CONTAINING THE EXACT SAME INFORMATION) IS REQUIRED TO REGISTER A CHANGE OF OWNERSHIP OF A VEHICLE. 2. NORTHWEST TERRITORIES LAW ALSO REQUIRES A VEHICLE BE INSURED PRIOR TO REGISTRATION. DOCUMENTED PROOF OF AUTOMOBILE INSURANCE MUST BE PRESENTED. 3. PLEASE BE PREPARED TO PRESENT THE ABOVE INFORMATION AT THE TIME OF REGISTRATION. 4. THE BUYER MAY CONDUCT A SEARCH FOR LIENS AND ENCUMBRANCES REGISTERED AGAINST THE PARTY SELLING THE VEHICLE BY CONTACTING THE DEPARTMENT OF JUSTICE, LEGAL REGISTRIES DIVISION, AT (867) 873-7493 5. THIS FORM IS PROVIDED AS A COURTESY BY THE ROAD LICENSING AND SAFETY DIVISION OF THE DEPARTMENT OF TRANSPORTATION, GOVERNMENT OF THE NORTHWEST TERRITORIES. IT IS INTENDED TO HELP ENSURE INFORMATION REQUIRED FOR THE REGISTRATION OF A VEHICLE BY THE NEW OWNER IS CONTAINED IN THE BILL OF SALE. THE GOVERNMENT OF THE NORTHWEST TERRITORIES ASSUMES NO LIABILITY FOR THE USE OF THIS DOCUMENT IN RESPECT OF THE SALE OF THE DESCRIBED VEHICLE AND ANY LEGAL DISPUTES ARISING THEREFROM.