Registered motor vehicle trader: Yes
Motor vehicle trader registration number:
Contact: Sam Moore
(including GST, registration, and licensing)
Security Interest *
There is a security interest over this vehicle
registered of the Personal Property Securities Register:
WARNING: A security interest means that this vehicle could be a security for a loan and could be repossessed. You should check the back of this notice for information about the Personal Property Securities Register.
Make and model:
Vehicle year *
Actual distance the vehicle has travelled *:
Radio receiver capability *
Can receive 88 to 109 MHz
without use of a band expander:
Vehicle Identification Number or chassis number
Warrant or Certificate of Fitness
Warrant or Certificate of Fitness expiry date
Vehicle licence expiry date
Registered vehicle *
Registration plate number
Year first registered in New Zealand:
28/06/2013 12:00:00 AM
Re-registered vehicle *
Operating fuel type
Road user charges apply *
Outstanding road user charges *
INFORMATION ABOUT USED IMPORTED VEHICLES
Year first registered overseas
Country where last registered
Imported as damaged vehicle *
If you buy this motor vehicle, the trader MUST give you a copy of this notice to keep.
I __________________________________ (name of trader) have supplied to the buyer a copy or electronic version of this notice, including a copy of the information on the back of this notice.
I __________________________________ (name of buyer) have received a copy or electronic version of this notice, including a copy of the information on the back of this notice.