Reg 119 – Fill Out and Use

A Public Service Agency	CERTIFICATE OF REPOSSESSION
				VEHICLE LICENSE NO. OR VESSEL CF NO.		LICENSE EXP. DATE
		SECURITY INTEREST
VEHICLE OR HULL IDENTIFICATION NO.			MAKE OF VEHICLE OR VESSEL BUILDER	FOR MOTORCYCLES ONLY
				Engine No.:
NAME OF PERSON COMPLETING CERTIFICATE				TITLE OF PERSON COMPLETING CERTIFICATE
REPRESENTING (NAME OF BANK, COMPANY, ETC.)
ADDRESS			CITY	STATE	ZIP

The above named person does hereby certify that ________________________________________________________

PERSON, BANK, COMPANY, ETC.

is the legal owner within the meaning of the Vehicle Code of the above described vehicle or vessel, and that as allowed under

a security interest created on the ___________________________ day of _________________ in the year of ________ ,

_________________________________________________________________________________________________
CHECK ONE	PERSON, BANK, COMPANY, ETC.
repossessed	authorized repossession of the above described vehicle on _________________________________
	DATE

from ____________________________________________________________________________________________

whose post ofice address is/was: _____________________________________________________________________

for the following reasons: ____________________________________________________________________________

Possession of the vehicle or vessel taken at _____________________________________________________________

ADDRESSCITYSTATEZIP

Vehicle or vessel was sold through auto auction ____________________________________	_____________________
NAME OF AUTO AUCTION	DEALER NO.

on________________________________ at ____________________________________________________________

DATE	ADDRESS	CITY	STATE	ZIP
		OR

Vehicle or vessel was sold at __________________________________ Sale on ________________________________

PUBLIC OR PRIVATEDATE

To ______________________________________________________________________________________________

_________________________________________________________________________________________________

ADDRESS

CITY

STATE

ZIP

I further certify that at least ive (5) days written notice of intent to sell this repossessed vehicle or vessel was given by mail to all persons liable under the security agreement as required by Commercial Code Section 9504 and that neither the debtor nor any other secured party exercised the right to redemption given in Commercial Code Section 9506 prior to the sale.

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

NOTE: Odometer disclosure for vehicle is required on complying title or separate statement.

REG 119 (REV. 11/2007) WWW

SIDE A

A Public Service Agency	CERTIFICATE OF REPOSSESSION
			VEHICLE LICENSE NO. OR VESSEL CF NO.		LICENSE EXP. DATE
	CONDITIONAL SALE CONTRACT
VEHICLE OR HULL IDENTIFICATION NO.			MAKE OF VEHICLE OR VESSEL BUILDER
NAME OF PERSON COMPLETING CERTIFICATION			TITLE OF PERSON COMPLETING CERTIFICATION
REPRESENTING (NAME OF BANK, COMPANY, ETC.)
ADDRESS		CITY	STATE	ZIP

does hereby certify:

That said ________________________________ is the legal owner within the meaning of the Vehicle Code of the above

BANK, COMPANY, ETC.

described vehicle or vessel, and that as allowed under conditional sale contract dated ____________________________

CHECK ONE

_________________________________________________________	repossessed	authorized repossession of
BANK, COMPANY, ETC.

the above described vehicle or vessel on __________________________ from ________________________________

DATE

whose post ofice address is/was: _____________________________________________________________________

for the following reasons: ____________________________________________________________________________

Possession of the vehicle or vessel taken at		_____________________________________________________________
		ADDRESS	CITY	STATE	ZIP
Title and interest transferred	with	without recourse to:
________________________________________________________________			on ____________________________
	NAME			DATE

_________________________________________________________________________________________________

ADDRESS	CITY	STATE	ZIP
	OR
Vehicle or vessel was sold through auto auction ____________________________________			_____________________
		NAME OF AUTO AUCTION	DEALER NO.

on________________________________ at ____________________________________________________________

DATE	ADDRESS	CITY	STATE	ZIP
		OR

Sold at private sale to _______________________________________________________________________________

NAME

_________________________________________________________________				on ____________________________
ADDRESS	CITY	STATE	ZIP	DATE

I certify that at least ifteen (15) days written notice of intent [twenty (20) days if place of deposit in the mail or place of address

is other than California] to sell this repossessed vehicle or vessel was given by mail to all persons liable under the contract

as required by Civil Code Section 2983.2 and that no payment was made or received as therein provided prior to the sale.

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.