Title Acknowledgment Form

Title Acknowledgment Form

This Title Acknowledgment Form is made and entered into as of Month Day Year (the "Effective Date"), by and between Transferor: with principal address and Transferee: with principal address .

RECITALS

WHEREAS, Transferor is the registered owner of the subject title and related documents for the property or asset described below (the "Asset"); and

WHEREAS, Transferee desires to receive and Transferor desires to deliver the original title and any related documents evidencing Transferor's ownership or interest in the Asset; and

WHEREAS, the parties intend by this instrument to record certain acknowledgments, representations and warranties regarding the title, liens, encumbrances and delivery of documents relating to the Asset.

NOW, THEREFORE, in consideration of the mutual covenants and agreements set forth below, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Transferor and Transferee agree as follows:

1. DESCRIPTION OF ASSET AND TITLE

Asset Description:

Title Number: Issuing Jurisdiction/State:

VIN / Serial Number (if applicable):

2. ACKNOWLEDGMENT OF OWNERSHIP AND LIENS

Transferor hereby certifies and acknowledges that, as of the Effective Date, Transferor is the lawful owner of the Asset described above and has the full right, title and authority to deliver the original certificate of title and all related title documents, except for those liens or encumbrances expressly disclosed below.

There are no undisclosed liens, security interests, claims, or encumbrances affecting the title to the Asset: No undisclosed liens Liens disclosed below

3. REPRESENTATIONS AND WARRANTIES

Transferor represents and warrants to Transferee that: (a) Transferor is the sole legal and beneficial owner of the Asset or has the legal authority to deliver the title; (b) the title is genuine, valid and free from forgery or alteration; (c) no actions, claims, or proceedings are pending or, to Transferor's knowledge, threatened that would impair or invalidate the title; and (d) the information provided in this Form is true, complete and correct in all material respects.

4. DELIVERY OF TITLE DOCUMENTS

Transferor shall deliver to Transferee the original title certificate and all supporting documents reasonably necessary to transfer ownership to Transferee within days of the Effective Date. Delivery shall be made to the address for notices set forth in Section 7 below unless otherwise agreed in writing.

5. INDEMNIFICATION

Transferor agrees to indemnify, defend and hold harmless Transferee from and against any and all losses, liabilities, damages, costs and expenses (including reasonable attorneys' fees) arising from any breach of Transferor's representations, warranties or covenants contained in this Form, or from any undisclosed liens, claims or encumbrances affecting the title.

6. FURTHER ASSURANCES

Each party shall execute and deliver such further documents and instruments and shall take such other actions as may be reasonably necessary to carry out the intent and purpose of this Form and to effectuate the transfer of title.

7. NOTICES

All notices, demands or other communications required or permitted under this Form must be in writing and shall be deemed given when delivered personally, sent by certified mail (return receipt requested), or delivered by nationally recognized overnight courier to the parties at the addresses below or at such other address as a party may designate by notice in accordance with this Section.

8. GOVERNING LAW

This Form shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles that would apply the law of another jurisdiction.

9. ENTIRE AGREEMENT

This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written, regarding the subject matter of this Form.

10. SEVERABILITY

If any provision of this Form is held to be invalid, illegal or unenforceable under any applicable law, such provision shall be ineffective only to the extent of such invalidity or unenforceability and shall not invalidate the remaining provisions of this Form, which shall remain in full force and effect.

11. AMENDMENT AND WAIVER

No amendment, modification or waiver of any provision of this Form shall be effective unless in writing and signed by the party against whom enforcement is sought. The waiver by any party of a breach of any provision of this Form shall not operate or be construed as a waiver of any other or subsequent breach.

12. COUNTERPARTS

This Form may be executed in one or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Facsimile, scanned or electronic signatures shall be deemed to be original signatures for all purposes.

13. AUTHORITY

Each person executing this Form on behalf of a party represents and warrants that he or she is duly authorized to execute and deliver this Form on behalf of such party and that this Form is binding upon such party in accordance with its terms.

ADDITIONAL INFORMATION

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