Legal Voluntary Surrender Form

LEGAL VOLUNTARY SURRENDER FORM

This Voluntary Surrender Agreement (the Agreement) is made and entered into on Effective Date: , by and between Surrendering Party: whose address is ("Surrenderor"), and Recipient: whose address is ("Recipient").

RECITALS

WHEREAS, Surrenderor is the legal owner or lawful custodian of the property described below and desires to voluntarily surrender all right, title and interest in and to such property to Recipient; and

WHEREAS, Recipient agrees to accept the voluntary surrender, to assume possession, and to receive any title instruments or bills of sale necessary to effect transfer of the surrendered property; and

WHEREAS, the parties intend by this Agreement to set forth their mutual understanding and to provide for assignment, release and indemnification with respect to the surrendered property.

NOW, THEREFORE

In consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement, the following terms have the meanings set forth below:

"Property" means the tangible and intangible items, documentation, titles, keys, and related materials specifically described in Section 2 below that are subject to voluntary surrender.

"Effective Date" means the date set forth above and, for delivery purposes, the date of actual physical or constructive delivery of the Property to Recipient, as applicable.

2. DESCRIPTION OF PROPERTY

Surrenderor hereby surrenders the Property to Recipient. Provide a complete and accurate description of the Property being surrendered, including serial numbers, VIN, make, model, quantity and any identifying marks:

Vehicle Personal Property Animal Firearm Other

3. SURRENDER, TRANSFER AND TITLE

On the Effective Date, Surrenderor irrevocably surrenders and transfers to Recipient all right, title and interest in and to the Property, and delivers possession of the Property to Recipient. Surrenderor shall execute and deliver, without further consideration, such instruments of assignment, bills of sale, odometer statements, certificates of title and other documents reasonably necessary to effectuate the transfer of ownership and possession.

4. REPRESENTATIONS AND WARRANTIES

Surrenderor represents and warrants to Recipient that: (a) Surrenderor is the sole legal owner of the Property or otherwise has lawful authority to surrender the Property; (b) the Property is free and clear of any liens, encumbrances, security interests, leases and claims except as expressly disclosed in this Agreement; (c) to the best of Surrenderor's knowledge, any odometer, title, registration or ownership information provided is true and correct; and (d) Surrenderor has not granted any third party rights or licenses that would impair Recipient's ownership or use of the Property except as disclosed below.

5. RELEASE AND WAIVER

Upon transfer and acceptance of the Property by Recipient, Surrenderor releases, discharges and forever waives any and all claims, demands, causes of action, suits and liabilities of any kind, whether known or unknown, arising out of or relating to Surrenderor's prior ownership or possession of the Property, except for claims arising from Recipient's breach of this Agreement.

6. INDEMNIFICATION

Surrenderor shall indemnify, defend and hold harmless Recipient, and Recipient shall indemnify, defend and hold harmless Surrenderor, from and against any and all claims, losses, liabilities, damages, costs and expenses (including reasonable attorneys' fees) arising from breach of any representation, warranty or covenant in this Agreement or from any misrepresentation regarding title, ownership, liens or the condition of the Property.

7. RISK OF LOSS; INSPECTION

Risk of loss or damage to the Property shall transfer to Recipient upon physical or constructive delivery of the Property to Recipient at the Delivery Location. Recipient may, at its election and expense, inspect the Property prior to or upon taking possession. Any inspection findings shall not affect the operative transfer of title except where fraud or intentional misrepresentation by Surrenderor is established.

8. ADDITIONAL DOCUMENTS

The parties shall execute and deliver such further instruments and take such further actions as may be reasonably necessary to carry out the intent and provisions of this Agreement, including any filings required to perfect transfer of title or to record assignment of ownership.

Yes No

9. NOTICES

All notices, requests, consents, claims, demands, waivers and other communications hereunder shall be in writing and addressed to the parties at the addresses set forth below or at such other address for a party as shall be specified by like notice.

10. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of law principles. The parties submit to the exclusive jurisdiction of the state and federal courts located in that state for any action arising out of or relating to this Agreement.

11. ENTIRE AGREEMENT; AMENDMENT; WAIVER; SEVERABILITY; COUNTERPARTS

This Agreement constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings. Any amendment or modification of this Agreement must be in a writing signed by both parties. No waiver of any provision shall be effective unless in writing signed by the party against whom enforcement is sought. If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

12. CERTIFICATIONS

Each party certifies and acknowledges that: (a) it has read and understands this Agreement; (b) it has had the opportunity to seek independent legal advice; (c) the person signing below is authorized to execute this Agreement on behalf of the party; and (d) the representations and warranties contained herein are true and correct as of the Effective Date.

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