CERTIFICATE OF REPOSSESSION
A Public Service Agency
If legal owner is not shown on DMV records, the original or a certified copy of the conditional sale contract or security interest agreement must accompany this certification.
SECTION 1 — VEHICLE/VESSEL INFORMATION
SECTION 2 — REPOSSESSION INFORMATION
LEGAL OWNER (NAME OF BANK, FINANCE COMPANY, ETC., OR INDIVIDUAL HAVING A LIEN ON THIS VEHICLE OR VESSEL)
ADDRESS (INCLUDE SUFFIX [E.G., AVE., ST., ETC.] AND ANY UNIT NO. [INDICATE STE., ETC.]) |
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LIEN/INSTRUMENT TYPE UNDER WHICH THE DEFAULT OCCURRED (CHECK BOX) |
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DATE CONTRACT/AGREEMENT SIGNED/EXECUTED |
CONDITIONAL SALE CONTRACT |
SECURITY INTEREST AGREEMENT |
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DATE OF REPOSSESSION |
METHOD OF REPOSSESSION (CHECK BOX) |
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REPOSSESSION BY LICENSED REPOSSESSION AGENCY (B&PC §7500.2) |
VOLUNTARY SURRENDER BY DEBTOR |
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REPOSSESSION BY LEGAL OWNER OR A BONA FIDE EMPLOYEE OF THE LEGAL OWNER |
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OTHER (EXPLAIN): |
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REASON(S) FOR REPOSSESSION (CHECK BOX) |
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FAILURE TO PAY |
OTHER (EXPLAIN): |
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POSSESSION OF THE VEHICLE OR VESSEL TAKEN AT (ADDRESS) |
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REPOSSESSED FROM DEFAULTING DEBTOR(S) (NAME) |
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ADDRESS OF DEFAULTING DEBTOR |
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VEHICLE OR VESSEL WAS (CHECK BOX) |
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DISPOSITION DATE* |
DELIVERED TO AUTO AUCTION FOR SALE |
SOLD THROUGH AUTO AUCTION |
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SOLD AT PUBLIC SALE |
SOLD AT PRIVATE SALE |
LEASED/LICENSED |
RETAINED |
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NAME OF AUTO AUCTION, BUYER, OR LESSEE** |
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AUTOAUCTION DEALER NO. |
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*ENTER SALE OR LEASE DATE; IF DELIVERED TO AUTO AUCTION FOR SALE, ENTER DELIVERY DATE.
**ENTER BUYER OR LESSEE; IF DELIVERED TO AUTO AUCTION FOR SALE, ENTER NAME OF AUTO AUCTION; IF SOLD THROUGH AUTO AUCTION, ENTER BUYER’S NAME.
SECTION 3 — CERTIFICATION
I certify that I, or the firm, company, or corporation I am authorized to represent, am the legal owner within the meaning of California Vehicle Code §§370, 9840 of the above described vehicle (including trailer) or vessel. In good faith and in a commercially reasonable manner, the vehicle or vessel was lawfully repossessed, taken into the legal owner’s possession and disposed of, after default under the terms of a valid lien contract/ agreement, and in full accordance with all applicable California statutes.
CONDITIONAL SALE CONTRACT (California Civil Code [Civil Code]) – I further certify that, except for a vehicle seized as described in Civil Code §2983.3 (b) (6), at least fifteen (15) days (twenty [20] days if place of deposit in the mail or place of address is outside California) written notice of intent to sell/dispose this repossessed or surrendered vehicle or vessel, in proper form and content, was given by personal service or by mail at the last known address to all persons liable under the contract as required by Civil Code §2983.2, and that the debtor/obligor has not cured or was unable to cure (Civil Code §2983.3) the default which led to the repossession.
SECURITY INTEREST AGREEMENT (California Commercial Code [Com. Code]) – I further certify that, in proper form and content, a written notice of intent to sell/dispose this repossessed vehicle or vessel was sent to, or notification waiver agreement (Com. Code §9624) obtained from, all persons liable under the security agreement as required by and in the reasonable timeliness stated in Com. Code §§9611-9614, and that neither the debtor nor any other secured party exercised the right to redemption given in Com. Code §9623 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. I further certify (or declare) under penalty of perjury that the repossession was conducted in accordance with the requirements of California Military and Veterans Code §§407, 408, 409.1, and 409.3, and with the requirements of §§3952, 3953, and 3958 of Title 50 of the United States Code.
PRINTED NAME OF AUTHORIZED AGENT SIGNING FOR COMPANY |
TITLE OF AUTHORIZED AGENT SIGNING FOR COMPANY |
DAYTIME TELEPHONE NUMBER |
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SIGNATURE OF LEGAL OWNER (COMPANY NAME AND AUTHORIZED AGENT’S COUNTERSIGNATURE) |
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NOTE: Odometer disclosure for vehicle is required on Certificate of Title or separate odometer statement. |
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REG 119 (REV. 1/2019) WWW |
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