EFTA00124048 Object 006E63WJ (Page 4 of 18) RETAIL INSTALMENT CONTRACT SIMPLE FINANCE CHARGE River Name and Address Address 2125 North Avenue, New York, NY 10024 City, State, Zip Code BROOKLYN, NY 11234 No No You are the buyer and the seller. If any, may your vehicle be for sale on an account. By signing this contract you agree to the terms of the agreement on the front and back of this contract. You agree to the Seller. Creditor(s) will "on" this contract. The Truth-Length Disclosures below are part of this contract. FEDERAL VENTURE IN LENDING DISCLOSURES AMOUNT OF PAYMENT RATE Finance Credit Amount Total of Payment Total Rate $3,648 $3,648 $29,251.41 $29,251.41 $4,000.00 Vehicle Payment Amount Total of Payment Total Rate 72 $351.27 Monthly Interest 6/11/17 Or Air Pollution Late Charge is not a payment of interest. If any, may it be paid at a late rate. Repayment is payable by mail, pay by post or by cash immediately. Other charges including information about impairment. Additional Information. This contract for some purposes includes information about impairment. CERTIFICATION OF MORTGAGE 1. Cost Price Index: 1.25 (75% less) 2. Total Amount: 0.000 Total Mortgage Amount: N/R Less Loan Debt (Loan Borrowed) N/R Equity Net Trade N/R Other RATES: 1.600,000.00 Other Charges including Amount Index (or You Should) 2. Other Charges including Amount Index (or You Should) 3. Other Charges including Amount Index (or You Should) 4. Other Charges including Amount Index (or You Should) 5. Other Charges including Amount Index (or You Should) 6. Government Entity Register Number: 26.75 Regulated Land Use: N/R Government Title Register Number: 26.75 EFTA00124049 Object 006E63WJ (Page 5 of 18) OTHER IMPORTANT AGREEMENTS ## 1. FINANCE CHARGE AND PAYMENTS we will issue Finance Charge. We will figure the Finance Charge on a daily basis at the Annual Percentage Change. b. **How we will apply payments.** We may apply each payment to the earned and unpaid part of the Finance Charge, to the unpaid part of the Amount Financed and to other amounts you own under this contract in any order we choose. m. **How late payments or early payments change what you can pay.** We based the Finance Change, Total of Payments, and Total Sale Price shown on the front on the assumption that you will make every payment on the day it is due. Your Finance Change, Total of Payments, and Total Sales Price will be paid you pay daily and less if you pay early. Changes may be made to your payment or, at our option, more or fewer payments of the same amount as your scheduled payment with a smaller final payment. We will send you a notice telling you about these changes before the first scheduled payment is due. d. You may prepay. You may prepay all or part of the unpaid part of the Amount Funded at any time without penalty. If you do so, you must pay the earned and unpaid part of the Finance Change and all other amounts due up to the date of your payment. ## 2. YOUR OTHER PROMISES TO US a. if the vehicle is damaged, destroyed, or missing. The following paragraph does not apply if the box in the GAP Weaver Notice on the front of this contract is checked. You agree to pay us all you owe under this contract even if the vehicle is damaged, destroyed, or missing. The terms and conditions of your liability if the vehicle is damaged, destroyed, or missing are described in a separate document you sign. The document is a part of this contract. b. **Using the vehicle.** You agree not to remove the vehicle from the U.S. or Canada, or to sell, rent, lease, or transfer any interest in the vehicle or this contract without our written permission. You agree not to expose the vehicle to moisture, confiscation, or involuntary transfer. If we pay any repair bills, storage bills, fines, fees, or charges on the vehicle, you agree to repay the amount when we ask for it. c. **Security Interest.** - The vehicle and all parts or goods put on it. *All air or goods received (grounded) for the vehicle; *AI insurance, maintenance, service, or other contracts* * All proceeds from insurance, maintenance, service, or other permits, we finance for you. This includes any applicable fees charged by your insurer. This secures payment of all you owe on this contract. It also secures your other agreements in this contract. You will make sure the title shows our security interest (keep in mind that we are not obligated to pay any money to the recipient) to be placed on the file without our written permission. ## d. Insurance you must have on the vehicle You agree to have physical damage insurance coverage boxed of or damage to the vehicle for the term of this contract. The insurance must cover our interest in the vehicle. If you do not have this insurance, we may, if we choose, buy physical damage insurance. If we decide to buy physical damage insurance, we may either buy insurance that covers your interest and our interest in the vehicle, or buy insurance that covers only our interest. If we buy either type of insurance, we will tell you which type and the charge you must pay. The charge will be the premium for the insurance and a finance charge computed at the Annual Percentage Rate shown on the front of this contract. iny the university is尔法 or意菏, yiage that we may use iny the university is尔法 or意菏, yiage that we may use e. What happens to returned insurance, maintenance, service, or other contract charges. If we get a refund of insurance, maintenance, service, or other contract charges, we may subtract the refund from what you own. 3. IF YOU PAY LATE OR BREAK YOUR OTHER PROMISSES | | | | :--- | :--- | | a. You may own late charges. You will pay a late charge on each late payment as shown on the front. A failure of a late payment or late charge does not excuse your late payment or mean that you may keep making late payments. | | If you pay less, we may also take the steps described below. b. You may have to pay all your own taxes if you break the contract on this contract at once subject to any right you have on this contract at once subject to any right you have to reinstate the contract for less (see below). Default means: * You do not pay any payment on time; - You give false, incomplete, or inadmissible information on a credit application; - You start a proceeding in bankruptcy or one is started against you or your property on - The amount you will own will be the unpaid part of the Amount Finance plus the earned and unpaid part of the Proposed Finance Charge and the Finance Charge, any late charges, and any amounts due because you defaulted. - You break any agreements in this contract. c. You may have to pay collection costs. If we hire an attorney who is not our salaried employee to collect what you own, you will pay the attorney's fee and court costs as well. If you are not a salaried employee, you will pay will be 15% of the amount you own. d. We may take the vehicle from you, if you default, we may take (reposses) the vehicle from you if we go so peacefully and the law allows it. If your vehicle help an electronic tracking device, you agree that we may use the device to find the vehicle. If we take the vehicle, any accessories, equipment, and replacement parts we stay with may be lost. We may store them for you at your expense. If you do not ask for these items back, we may dispose of them as the law allows. a. How you can get the vehicle back if we take it. If we repossess the vehicle, you may pay to get it back. If two things are true, you have the right to get the vehicle back by paying all past dues payments, any charges, and any expenses incurred to stealing the vehicle, building it, and preparing it for sale (mortality). First, you must have bought the vehicle previously for personal, family, or business purposes. Second, you must have an installment payment on time. Third, we will tell you how much to pay to get the vehicle back. Your right to get the vehicle back when we sell it. ## f. We will sell the vehicle if you do not get it back. If you do not receive, we will sell the vehicle. We will send you a new one. We will apply the money from the sale, less allowed expenses, to the amount you own. Allowed expenses are expenses we pay as a direct result of taking the vehicle, holding it, preparing it for sale, and selling it. Attorney fees and court costs the low permit费 also allowed expenses. If any money is incurred (payup), we will pay it to you unless the law requires us to pay it to someone else. If money from the sale is not enough to pay the amount you own, you must pay upfront. If you do not pay upfront, you may change your interest at a rate not exceeding the highest tax rate until you pay. g. What we may do about optional insurance, maintenance, service, or other contracts. This contract may contain charges for optional insurance, maintenance, service, or other contracts. If we demand that you pay all your own at once or we repress the vehicle, you agree that we obtain refunds of unmeasured charges to reduce what you own or repair the vehicles. If the vehicle is a total loss because it is certificated, damaged, or stolen, we may claim benefits under these contracts and cannot them to obtain refunds of unmeasured charges to reduce what you own. 4. Used Car Buyers Guide. The information you see on the window form for this vehicle is part of this contract. Information on the window form overrides any contrary provisions in the context of sale. Spanish Translation: Guía para compromiso de vehículo usado. La Información que ve en el formulario de la ventana pasa esta vehículo forma parte del presente contrato. La Información del formulario de la ventana deja sin efecto toda disposición en contrario contida en el contrato de venta. ## 5. SERVICING AND COLLECTION CONTACTS You agree that we may try to contact you in writing, by e-mail, or using predefined artificial voice messages, text messages, and automatic telephone dialing systems, as the law allows. You also agree that we may try to contact you in these and other ways at your convenience. Your telephone number is a cell phone number or the contact results in a change to you. ## 6. APPUCABLE LAW Federal law and the law of the state of our address shown on the front of this contract apply to this contract. NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFINES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PURSUANT HERITO OR WITH THE PROCEDES HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER. The preceding NOTICE applies only to goods or services obtained primarily for personal, family, or household use. In all other cases, Buyer will not assert against any subsequent holder or assigne of this contract any claims or defenses the Buyer (debtor) may have against the Seller, or against the manufacturer of the vehicle or equipment obtained under this contract. Form No. 833-097 15/16 EFTA00124050 Object 006E63WJ (Page 6 of 18) Dealer Phone #: 718-937-3700 Dealer Fax #: 718-973-3700 Dealer Name: MAJOR WORLD CHEVROLET LLC INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED INSTRUCTIONS: You may apply for credit in your name alone, or not if you are required (1) Please indicate whether you are applying for: Individual Credit, Joint Credit, Community Property State, Business Application (2) If you are applying for any non-credit card, you must name and lay on your own income or assets and not the income or amount of the credit card, completed only Section A (3) If you are applying for part credit with another person, complete sections A and B. We need to apply for part credit. Applicant Do Applicant *If you are married and live in a community property state, please complete Section A about yourself and Section B about your spouse. You must sign this application. Your spouse must sign this application only if she/was to be a Co-Applicant. A. APPLICANT INFORMATION Last Name First Name Middle Name Social Security Number Birth Date Address Act # / Suite # P.O. Box Rural Route City BROOKLYN State NY Zip 11234 Home Phone * Cell Phone * Residential Status Homeowner Rent Family Other Time at Address 8 Yrs Mos. Rental/Mortg. Pmt $500.00 E-Mail Address Driver's License No. Driver's License State Time at Previous Address Yrs Mos. Previous Address (if less than 2 years) Act # / Suite # P.O. Box Rural Route City State Employer Name NY STATE ASSEMBLY Employed Unemployed Self-employed Military Retired Student Other Salary Salary Type Occupation Length of Employment Work Phone Number 79 500.00 Weekly Bi Weekly Monthly Annually ASSEMBLER Previous Employer Name Previous Employment Type Employed Unemployed Self-employed Military Retired Student Other Previous Occupation Length of Employment Yrs Previous Work Phone Number Memory, credit support, or separate maintenance income need not be provided if you do not choose. Other Income (Monthly) Source of Other Income Application is accurate AGREEMENT You understand and agree that you are applying for credit by providing the information to complete and submit this credit application. We may keep this application and any other application submitted to us for information whether or not the application is approved. You certify that the information on the application and in any other application submitted to us is true and complete. You understand that false statements may subject you to criminal action. The words, you and your consent may mean that you receive the application. You authorize us to submit this application and any other application in accordance with the proposed transaction to our behalf CERTIEY THAT YOU HAVE READ AND AGREE TO THE TERMS AND DISCLOSURES ON THE PAGES OF THIS APPLICATION. DT Sr10 Printed on 12/12/2016 at 05:14 PM EFTA00124051 Object 006E63WJ (Page 7 of 18) # FEDERAL NOTICES IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT If applicable to your credit transaction, to help the government fight the funding of terrorism and money laundering activities, Federal law requires financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, you will be asked for your name, address, date of birth, and other information to identify you. You may also be asked to see your driver's license or other identifying documents. ## STATE NOTICES California Residents: An applicant, if married, may apply for a separate account. Maine and Tennessee Residents: You must have physical damage insurance covering loss or damage to the vehicle for the term of the contract. For a lease, you must also have the liability insurance as described in the lease. You may purchase required insurance through any insurance agent or broker and from any insurance company that is reasonably acceptable to us. You are not required to deal with any of our affiliates when choosing an agent, broker or insurer. Your choice of a particular insurance agent, broker or insurer will not affect our credit decision, so long as the insurance provides adequate coverage with an insurer who meets our reasonable requirements. New Hampshire Residents: If you are applying for a balloon payment contract, you are entitled, if you ask, to receive a written estimate of the monthly payment amount for refinancing the balloon payment in accord with the creditor's existing refinance programs. You would be entitled to receive the estimate before you enter into a balloon payment contract. A balloon contract is an installment sales contract with a final scheduled payment that is at least twice the amount of one of the earlier scheduled equal periodic installment payments. New York Residents: In connection with your application for credit, a consumer report may be obtained from a consumer reporting agency (credit bureau). If credit is extended, the party or parties extending credit or holding such credit may order additional consumer reports in connection with any update, renewal or extension of the credit. If you ask, you will be told whether a consumer report was requested and, if so, the name and address of any consumer reporting agency (credit bureau) from which such credit report was obtained. Ohio Residents: Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. Rhode Island Residents: Consumer reports may be requested in connection with this application. Buyer has the right of free choice in selecting an insurer to provide insurance required in connection with this transaction subject to our reasonable approval in accordance with applicable law. Vermont Residents: You authorize us and any financial institution with which this credit application is shared, and each of their respective employees or agents, to obtain and verify information about you (including one or more credit reports, information about your employment and banking and credit relationships) that they may deem necessary or appropriate in evaluating your credit application. If your credit application is approved and credit is granted, you also authorize the parties granting credit or holding your account, and their respective employees and agents, to obtain additional credit reports and other information about you in connection with reviewing the account, increasing the available credit on the account (if applicable), taking collection on the account, or for any other legitimate purpose. Married Wisconsin Residents: No provision of any marital property agreement, any unilateral statement under Wis. Stat § 766.59 or any court decree under § 766.70 applied to marital property adversely affects our interest unless you furnish a copy of the agreement, statement, or court decree or we have actual knowledge of such adverse provision before credit is granted. If you are making this credit application individually and not jointly with your spouse, complete Section A about yourself and Section B about your non-applicant spouse. Your non-applicant spouse should not sign the credit application if you are applying for individual credit. Page 2 of 3 © 2016 Dealertrack, Inc. All rights reserved. DT 5/16 Printed on 12/12/2016 at 05:14 FM EFTA00124052 Object 006E63WJ (Page 8 of 18)
FOR MAJOR WORLD CHEVROLET LLC USE ONLY DEALER SECTION
Dealer #Vehicle Type UsedMileage 25000Product Type RetailStock NumberSourceCertified Pre Owned
Year 2015Make JEEPModel WRANGLER UNLIMITEDTrim 4WD 4DR SPORTVN
Term 72Cash Selling Price 25,000.00Sales Tax 2,218.00T & L 174.00Cash Down 6,000.00Front End FeesRebateNet TradeAoq FeeUnpaid Balance 21,392.00
Accident/Health Ins.Credit Life InsuranceGapService PlanBack-End FeesEst. Amt. Financed 21,392.00
MSRPInvoice/Wholesale Value 29,775.00Wholesale Source NADARetail ValueRetail SourceEstimated PaymentRequested APR
Vehicle BookoutBookout DateLender Program
Vehicle Options
TRADE INFORMATION
YearMakeModelTrim
LienholderMonthly Payment
Page 3 of 3 © 2016 Digitrack, Inc. All rights reserved Printed on 12/12/2016 at 05:14 PM DT S/16 EFTA00124053 Object 006E63WJ (Page 9 of 18) N.Y.C., D.C.A. NO. 2003442 MASOR WORLD # Major World Chevrolet, L.L.C. # 43-40 Northern Blvd. • Long Island City, NY 11101 • (718) 937-3700 ALPHONSO CLARK SOLD TO: SERGIO AMESTEGUI BROOKLYN, NY 11234 UC 134828
MADE 2015MODELNEW OF USEDSERIAL/IDENT NO.COLORSTOCK NO.26889
JEEPWRANGLERUBRPRICE OF CAR4 -25,000.00
N/A
0.00
N/A
0.00
37.00
88.75
70.00
2,218.75
27,414.50
MV 50 NO.SUSED CAM MILEAGEKEY NO.IGNTHK
TEMP NO.24,104
OPTIONAL EQUIPMENT AND ACCESSORIES
JMWILL7@ADL.COM
CAPITAL ONE AUTO FINANCE
SETTLEMENT
DEPOSIT220 DN/A
CASH ON DELIVERY220 D6,000.00
USED CAR-240N/A
TYPEN/A
SER. NO.205N/A
720351.2721,414.50
  *Dealers optional fee for processing application for registration and/or certificate of title, and for securing special or distinctive plates. (If applicable). THIS IS NOT A DMV FEE "$75.00"
THIS VEHICLE RECEIVED IN GOOD CONDITION:
EFTA00124054 Object 006E63WJ (Page 10 of 18) EFTA00124055 Object 006E63WJ (Page 11 of 18) # NADA Official Used Car Guide Monday, December 12, 2016 ## Vehicle Summary NADA Values **Region:** Eastern - December 2016 Stock #:
Vehicle Description:2015 JEEP
Wrangler
Utility 4D Unlimited Sport 4WD V6
MSRP: $26,395 | Weight: | 4,075 | | :--- | :--- | | Mileage: | 24,009 | | :--- | :--- |
Rough Trade-InAverage Trade-InClean Trade-InClean LoanClean Retail
Base Value$25,975$27,475$28,700$25,850$31,050
Optional Equipment
Fixed Running Boards$50$50$50$50$75
Luggage Rack$50$50$50$50$75
Towing/Camper Pkg$350$350$350$350$400
Option Total$450$450$450$450$550
Mileage Adjustment$625$625$625$625$625
Total NADA Official Used Car Guide Values$27,050$28,550$29,775$26,925$32,225
J.D. Power and Associates assumes no responsibility or liability for any errors or omissions or any revisions or additions made by anyone on this report. All values are reprinted with permission of J.D. Power and Associates. Copyright 2016 J.D. Power and Associates EFTA00124056 Object 006E63WJ (Page 12 of 18) MV-82 (1/15) EFTA00124057 Object 006E63WJ (Page 13 of 18) CHANGES - Write new information about a current registration or title on page 1 of this form (for more information, refer to form MV-82.1. “Registerng/Titling a Vehicle in New York State.”) NAME CHANGE: Print the former name exactly like the former name is printed on the current registration or title. CHANGES: Describe any vehicle changes and the reasons for the changes. ## ADDITIONAL VEHICLE INFORMATION ➔ QUESTIONS 1-3 MUST BE COMPLETED. 1. I certify that, to the best of my knowledge, this vehicle has been or has not been wrecked, destroyed or damaged to such an extent that the total estimate, or actual cost, of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident, and for legal operation on the road or highways, is more than 75% of the retail value of the vehicle at the time of loss.(Checking the “has been” box means the vehicle must have an anti-theft examination before being registered, and that the title issued will have the statement “Rebuilt Salvage” on it.) 2. Is this vehicle registered for your personal use? ☐ Yes ☐ No If you marked "Yes", go to the next question (question 3) . If you marked "No", check any of these boxes that apply: ☐ This vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s): ☐ New York City (NYC) ☐ A jurisdiction that is not NYC that regulates taxis ☐ A jurisdiction that does not regulate taxis ☐ This vehicle is a passenger vehicle that is rented without a driver. ☐ This vehicle requires a permit for commercial operation. (Mark the box of the type of permit that was issued and write the permit number on the line.) ☐ NYS DOT Permit No. ___ ☐ Federal DOT Permit No. ___ The government owns this vehicle. This vehicle is used as (mark one) an ambulance If payment is received to carry passengers, mark this box □ a hearse or invalid coach □ an ambulette This vehicle is used exclusively as a hearse If payment is received to carry passengers, mark this box. This vehicle is a commercial tow truck with a gross vehicle weight rating of at least 8,600 pounds. ☐ This vehicle is used only as a farm vehicle. *(form MV-260F, Part 1. must be attached)* ☐ This vehicle is used only as an agricultural truck. ☐ This vehicle is subject to the Department of Transportation inspection requirements for the carriers that transport passengers. (For more information, refer to form MV-82.1P. "Inspection Requirements for Carriers Transporting Passengers".) 3. Has this vehicle been modified to change its registration class? □ Yes □ No If "Yes", explain ___. 4. This vehicle is a pick-up truck with an unladen weight that is a maximum of 5,500 pounds. This vehicle is never used for commercial purposes and does not have advertising on any part of it. I want (mark one): Passenger Plates Commercial Plates CERTIFICATION: The information I have given on this application is true to the best of my knowledge. I certify that the vehicle is fully equipped as required by the Vehicle and Traffic Law, and has passed the required New York State inspection within the past 12 months, or has qualified for a time extension (Form VS-1077) and will be inspected within 10 days. I also certify that appropriate insurance coverage is in effect, and that the vehicle will be operated in accordance with the Vehicle and Traffic Law. If I am applying for replacement registration items, I certify that the registration is not currently under suspension or revocation. If I have plates in a series reserved for a special group, I certify that I am still eligible to receive them; and that I have only one set of these plates. If I am using a credit card for payment of any fees in connection with my signature below, also authorizes use of my credit card. Print Name Here Sign Here [Print Name in Full - if registering for a corporation, print your full name and title] Print Additional Name Here Additional Signature Sign Her {Print Name in Full} [Sign Here] - Additional signature required for a partnership or if registering this vehicle in more than one name.] IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it, or deceiving or substituting in connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result in the revocation or suspension of the registration pursuant to regulations established by the Commissioner. The Department makes no representation that it will issue a certificate of title or transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation required to establish ownership of the vehicle is submitted and deemed to be satisfactory. Pending review of this application, neither the Commissioner of the Department of Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs performed, improvements made or work done to the vehicle referenced in this application. CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT: My signature authorizes ___ to use my credit card for payment of fees in connection with this application, and I understand that I must be present for this transaction. Sign ♥ Here [Cardholder-Sign Name in Full] To Be Completed by a Registered New York State Dealer Only—List any additional Lienholders Lien Filing Code (Assigned by DMV) ___ Lienholder Name ___ Mailing Address ___ (Number and Street) (City) (State) (Zip Code) Lien Filing Code (Assigned by DMV) ___ Lienholder Name ___ Mailing Address ___ (Number and Street) (City) (State) (Zip Code) NY DEALER CERTIFICATION: I certify that all information provided on this application is true. I take responsibility for the integrity of the papers delivered to the Motor Vehicles office. (Signature of Dealer or Authorized Representative) MV-82 [1/15] EFTA00124058 Object 006E63WJ (Page 14 of 18) EFTA00124059 Object 006E63WJ (Page 15 of 18) # ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY CERTIFICATE OF INSURANCE Date of Certificate : 12/13/2016 Policy Effective: 12/12/2016 until 06/13/2017 Description of the vehicle: 2015 JEEP JEEP WRANGLER The person or organization designated below is described in the policy as: Lienholder CAPITOL ONE PO BOX 255605 SACRAMENTO ## THE FOLLOWING COVERAGES AND LIMITS ARE IN FORCE ON THE ABOVE DESCRIBED VEHICLE | AA | Bodily Injury | $100,000/$300,000 | | :--- | :--- | :--- | | BB | Property Damage | $100,000 | | :--- | :--- | :--- | | SS | Uninsured Mot Bodily | $100,000/$300,000 | | :--- | :--- | :--- | | CC | Medical Payments | $100,000 | | :--- | :--- | :--- | | HS | Comprehensive With Full Glass | $1,000 | | :--- | :--- | :--- | JJ Towing and Labor (Occ) $125 | UU | Rental Reimbursement | $50/day | | :--- | :--- | :--- | | VA | Personal Injury Protection | 02 | Deductible | | :--- | :--- | :--- | :--- | | VA1 | Personal Injury Protection | $0 | Deductible | | :--- | :--- | :--- | :--- | | | (Ded) | | | VB Additional Personal Injury VB03 Protection THE LOSS PAYABLE CLAUSE OF SUCH POLICY PROVIDES: "The company reserves the right to cancel such policy at any time as provided by its terms, but in such case the company shall notify the Lienholder when not less than ten days thereafter such cancellation shall be effective as to the interest of said Lienholder therein and the company shall have the right, on like notice, to cancel this agreement." THE ADDITIONAL INTEREST ENDORSEMENT OF SUCH POLICY, IN PART, PROVIDES: "...such insurance as is afforded by the policy "for automobile liability insurance listed...hereof applies also to the person or organization named as Additional Interested Party "As respects such...interest, no cancellation...and no endorsement...adversely affecting such additional interest, shall be effective until ten (10) days following the mailing of EFTA00124060 Object 006E63WJ (Page 16 of 18) ## NEW YORK STATE INSURANCE IDENTIFICATION CARD ## 743 ALLSTATE FIRE AND CAS INS Name & Address of Issuer JA Agency Agency 50-30 Northern BI Long Island City NY 11101 (718) 530-1802 An authorized NEW YORK insurer has issued an Owner's Policy of Liability Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of the NEW YORK Vehicle and Traffic Law to: BROOKLYN NY 11234 ## Policy Number Effective Date 12/12/2016 Expiration Date 02/10/2017 12:01 a.m. 12:01 a.m. (Not acceptable to obtain registration after 45 days from effective date.) Applicable with respect to the following Motor Vehicle: Vehicle Identification Number *REPLACEMENT VEHICLE* ## THIS ID CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND WARNING: Any person who issues or produces an ID card knowing that an Owner's Policy of insurance is not in effect may be committing a misdemeanor. In addition, a person who presents an ID card if insurance is not in effect may be committing a misdemeanor. The name of the registrant and the name of the insured must coincide. REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE (RE-REGISTRATION) USING THE REPLACED VEHICLE'S CURRENT REGISTRATION. FS-20 ## NEW YORK STATE INSURANCE IDENTIFICATION CARD ## 743 ALLSTATE FIRE AND CAS INS Name & Address of Issuer JA Agency US Agency 50-30 Northern BI Long Island City NY 11101 (718) 530-1802 An authorized NEW YORK insurer has issued an Owner’s Policy of Liability Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of the NEW YORK Vehicle and Traffic Law to: BROOKLYN NY 11234 ## Policy Number Effective Date 12/12/2016 Expiration Date 12:01 a.m. 02/10/2017 12:01 a.m. (Not acceptable to obtain registration after 45 days from effective date.) Applicable with respect to the following Motor Vehicle: Vehicle Identification Number ## *REPLACEMENT VEHICLE* ## THIS ID CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND WARNING: Any person who issues or produces an ID card knowing that an Owner's Policy of insurance is not in effect may be committing a misdemeanor. In addition, a person who presents an ID card if insurance is not in effect may be committing a misdemeanor. The name of the registrant and the name of the insured must coincide. REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE (RE-REGISTRATION) USING THE REPLACED VEHICLE'S CURRENT REGISTRATION. FS-20 FAX: Scanable Bar Code ## FAX INSTRUCTIONS: 1. The entire page must be faxed. 2. If submitted to DMV, either the entire page or the second ID card and large scanable bar code will be retained 3. A faxed ID card must be replaced with a scanable ID card within 14 days of the effective date. 4. DMV will not accept a faxed ID card without a scanable barcode EFTA00124061 Object 006E63WJ (Page 17 of 18)
Major World Chevrolet
(718) 937 - 3700
(718) 937 - 9770 Fax
Major World Chrysler Jeep Dodge Ram
(718) 786 - 8300
(718) 786 - 8301 Fax
# Major World (718) 937 - 4545 (718) 937 - 0562 Fax | | | | :--- | :--- | | MWC: DMV# 7117189 / DCA# 2003442 | | | MWCDJR: DMV# 7118172 / DCA# 2012157 | | | MW: DMV# 7117189 / DCA# 2003442 | | PERSONAL REFERENCE SHEET (MUST BE COMPLETED) BUYERS NAME: ___ HOME PHONE #: ___ ## REFERENCES: LANDLORD or MORTGAGE COMPANY NAME: ___ ADDRESS: ___ PHONE: ___ NAME: ___ RELATIONSHIP:___ ADDRESS: ___ PHONE: ___ NAME: ___ RELATIONSHIP:___ ADDRESS: ___ PHONE:___ NAME: ___ RELATIONSHIP:___ ADDRESS: ___ PHONE: ___ EFTA00124062 Object 006E63WJ (Page 18 of 18) EFTA00124063