Texas Department of Transportation
RRISTRATION RENEWAL RECEIPT
COUNTY; GREGG
ThE NAME:
PLATE HO:
DOCUMENT NO;
TIME; 08:1mM
EMPLOYEE ID 0000010
KIRK SHIELDS
DATE; 07/28/2009
EF?EcTIVE DATE: 07/7f7qO9
EXPIRATION DATE: f2G1OI
TRA7ISACT!ON ID:
Current
Registration
Expiration Date
OWNER NAN AND ADDRESS
-
-
RIS’:RATICEJ CLJS: TRUCK-LESS/SQL.
PLATE TYPE: TRUTE PLT
ORGANIZATION:
STICKER TYPE: WE
PREVIOUS PLATE NO:
VEHICLE ID
tXICA.WN HO:
MODEL:
YR/MAKE: J992/T0YT
EMPTY NT: 2600
CARRYING CAPACITY;
DODY VEHiCLE IDENTIFICATION NO;
....
INVENTORY ITF.MS)
TRUCK PT.T
WINDSHIELD STICKER
YR
2010
VEHICLE CLASSIFICATION
TYLE
0
PASS-ThE
OK
UMI’l’ NO:
GROSS NT: 600
TONNAGE: .00
TRAVEL TRI.,R LENGTH; 0
FEES ASSESSED
WINDSHIELD STICKER
REG FEE-OPS
REFLECTORIZATION FEE
CNTY ROAD RRIDGE ADD-ON FEE
AUTOr4AT.WN PEE (LARGE CNTY)
TOTAL
VEHICLE RECORD NOTATIONS
RELEASE OF SONAL INFO RESTRICTED
ACTUAL MILEAGE
1 TON
$
36.
7.50
0.30
10.00
1.00
$
4874
$
METHOD O! PAYMENT AND ?AYMENT AMOUNT:
CHECK II
48.74
S
TOTAL AMOUNT PAID S
48.74
How to VeyRegistration:
1. Check the cwrent registraon
expiration date. Regisfration is
issued in 12 month increments.
THIS RECEIPT TO BE CARRIED IN ALL COMMERCIAL VEHICLES.
reqoirs a:iadditional $ .00 fm (1rdy
included) in COUnt,eS wh 50,000 or more veuc1e.
ORLOINAL
VTR.40944TS (REV O:9 (1*0 4462S)
NOTE: This document does not
establish vehicle ownership time
period. Separate documentation
d d
ii b
DUPLICATE RECEIPT
COUNTY: GREGG
PLATE NO:
DOCUMENT NO:
TAC NAME: KIRK SHIELDS
DATE;: 07/28/2009
TIME; 04;3SPM
EMPLOYEE ID:
EFFECTIVE DATE: 03/01/2009
EXPIRATION DATE: 12/2010
TRANSACTION ID:
OWNER NAME AN]) ADDRESS
Current
Registration
Expiration Date
REGISTRATION CLASS: PASSENGER-LESS/EQL 6000
PLATE TYPE: PERSONALIZED PLT
ORGANIZATION: PERSONALIZED
Previous
STICKER TYPE: WS
Registration
• PREVIOUS PLATE NO:
Expiration Date
PREVIOUS EXP MO/YR: /2009
VEHICLE CLASSIFICATION:
CUSTOMER ic,
ES PAID: $110.80
VEHICLE IDENTIFICATION NO:
UNIT NO:
YR/MAKE: 2007/HOND MODEL: UEX BODY ]T x1• 4D
CARRYING CAPACITY: 0
EMPTY WT: 3300
GROSS WT: 3300
TONNAGE; 0.00
BODY VEHICLE IDENTIFICATION NO:
TRAVEL TRLR LENGTH: 0
REGISTRATION ISSUE DATE:
02/06/2009
COUNTY OF REGISTRATION:
243
FEES ASSESSED
DUPLICATE REcEr’r
TOTAL
VEHICLE RECORD NOTATIONS
RELEASE OF PERSONAL INFO RESTRICTED
ACTUAL MILEAGE
PAPER TITLE
REGULAR TITLE
DOCUMENT TYPE
$
0.00
$
000
METHOD OF PAYMENT MD PAYMENT AMOUNT:
How to Verify Registration:
1. Check the current registration expiration date.
If this date is in the future, check the expiration date of the
previous registration. Registration is issued in 12 month
increments.
NOTE: This document does not establish vehicle
ownership time period. Separate documentation will be
needed.
THIS RECEIPT TO BE CARRIED IN ALL COMMERCIAL VEHICLES.
TOTAL AMOUNT PAID
$
0.00
Texas Department of Transportation
TITLE APPLICATION RECXPT
COUNTY: GREGG
TAC NAME: KIRK SF.IELBS
DATE: 07/28/2009
PLATE NO:
DOCUMENT N..
TIME:
PREV BOO NO;
OWNER NAI4!
EFFECTIVE DATE:
EXPIRATION DATE
TRANSACTION
0020AN
EMPLOYEE 10:
0000010
“
09
Current
Registration
Expiration Date
AND AI)DRESS
REGISTRATION ClASS; TRUCK-LF.SS/EQL.
PLATE TYPE; TRUCK PLT
1 TON
ORGANIZATION:
Q1’1rI5R
TYPE:
ES
VEHICLE IDENTIPICATION NO;
VRHICLE CLASSIFICATiON; PASS-TRE
YR/MAKE: 1992/TOYT
MODEL:
BOIJY STYLE; PK
UNIT NO;
EMPTY NT; 2600
CARRYING CAPACITY; LOGO
GROSS NT: 3600
T0NNAGE G.S0 TRAILER TYPE:
BODY VEHICLE IDENTIFICATION NO:
TRAVEL TRLR LI1G/WDTII; 0
PRSV OWNER NAME;
PREV CITY/STATE:
• TX
INVENTORY ITEM{S)
TRUCK PLT
WINDSHIELD STICKER
YR
2009
VEHICLE RECORD NOTATTONS
RELEASE OF PERSONAL INFO RESTRICTED
PAPER TITLE
FEES ASSESSED
TTLE APPLICATION FEE
TEXAS NORILITY 7UND FEE
TERP FEE
SALES TAX FEE
TRANSFER
WINDSHIELD STICKER
ERG FKE-DPS
REFLECTORIZATION FEE
UNTY ROAD BRIDGE ADD-ON FEE
1UTOMATTON FEE (LARGE CNTY)
TOTAL
ODOMETER READING: EXEMPT
BAND.
OWNERSHIP EVIDENCE; TEXAS TITLE
1ST LIEN
METHOD OF PAYMENT AND
CHECK
S
0.30
$
SALES TAX CATEGORY:
Oate of A
3RD LI.EN
inruanL/Sales Tax Date,
10.00
1.00
507.39
PAYMENT AMOUNT
.39
$
TOTAL AMOUNT PAID $
2ND LIEN
3 .00
15.00
S.0G
48 .76
2.50
41 .E4
1.00
557.39
SRLES/USE
4:7/02/2009
7500.QQ
Sales ?rice $
Less rrade In Aliowanca
0.00
Taxable Amount
7,500.00
Sales Tax Paid
468,25
Leea Giher State Tax Paid
0.00
Tax Penalty
0.00
TOTAL TAX PAID
4 6E 76
OStUb NO: 3004002001
Batch CoOlit; I
THIS RECEIPT TO BE CARRIED IN AU. COMMERCIAL VHICLSS.
Current law requires an additional $3.00 fee (already
included) in counties with 50,000 or moze vehicles.
THIS RECEIPT IS YOUR PROOF OF APPLICATION FOR CERTIFICATE OP TITLE AND REGISTRATION.
How to Verify Registration:
1. Check the current registration expiration date.
Registration is issued in 12 month increments
NOTE: This document does not establish vehicle ownership
time period. Separate documentation will be needed.
ORIGINAL
VTR500-RTS REV
io:go (0H1
4462S)
VEHICLE INQUIRY RECEIPT
COUNTY:
GREGG
TAC NAME: KIRK SHIELDS
DATE: 07/28/2009
TIME: 08:23AM
EMPLOYEE ID: 0000010
PLATE NO:
DOCUMENT NO:
EFFECTIVE DATE: qR/O1/’ç)08
EXPIRATION DATE: 17/2009
TRANSACTION ID;
Ot’NER NAME AND ADDRESS
Current
Registration
Expiration Date
REGISTRATION CLASS: PASSENGER-LESS/EQ1 6000
PLATE TYPE: DISABLED PERSON PLT
ORGANIZATION:
STICKER TYPE: WS
VEHICLE IDENTIFICATION NO:
VEHICLE CLASSIFICATION: PASS
YR/MAKE: 1993/DODG MODEL: SPI
BODY STYLE: 40
UNIT NO:
COUNTY NO: 14
EMPTY WT: 2900
CARRYING CAPACITY: 0
GROSS NT: 2900
TONNAGE: 0.00
TRAILER TYPE:
DODY VEHICLE IDENTIFICATION NO:
TRAVEL TRLR LNG/WDTH: 0 TIRE TYPE: P
REGISTRATION ISSUE DATE: 08/01/2008
ODOMETER READING: EXEMPT BRAND:
PREVIOUS PLATE NO:
‘‘VIOUS EXP MO/YR: 17/20081
PREV OWNER NAME
PREV CITY/STATE:
TX
PLATE AU 0
VEHICLE RECORD NOTAT1Ot
RELEASE OF PERSONAL INFO RESTRICTED
PAPER TITLE
-
I
ITitle
Previous
Registration
Expiration Date
Date
TITLE ISSUE DATE:
I
REGISTRATION FEES PAID
REGISTRATION
$ 54.30
DOCUMENT TYPE: REGULAR TITLE
1ST LIEN
SALES
SALES
TRADE
SALES
CUSTOMER NAJ1E: ANYBODY TEXAS
FEES ASSESSED
INQUIRY
TOTAL
2ND LIEN
3RD LIEN
TAX INFORMATION
PRICE
$
IN ALLOWANCE $
TAX PAID
$
$
2.00
$
2 .00
METI-IOD OF PAYMENT AND PAYMENT AMOUNT:
CHECK *
$
TOTAL AMOUNT PAID
$
How to Verify Ownership and Registration:
1. Check the title issue date. This date indicates the date title was
issued in the current owner’s name.
2. Check the current registration date. If this date is in the future,
check the previous registration expiration date. Registration is
issued in 12 month increments.
C00
0.00
10. 00
2.00
2.00
TxDOT: VTR Vehicle Titles and Registration: Inquiry by Registration (Single Plate Number)
# Texas Department of Transportation
I
MVlNet Printout
Page 1 of 1
I
VTR Inquiry by Registration (Single Plate Number)
Enter Expiration Year:
Current
Registration
Expiration Date
1.
Enter Plate Number:
-
SubrnfQiely
nguiry Menu
I
Remark Table
D #
1
IJUL!2009101
LIC
2900 GWT
2900
IJUL/2008[1WT
DISABLED PERSON PLT, STKR
REG CLASS
25
$ 54.30 BELL CNTY
TITLE
ISSUED
0/24/2007
METER N/A REG DT 08/01/2008
DODG MODL: SPI EDY S4D vEM LS:S
SALE PR
Issue Date
PLATE AGE:
LAST ACTIVITY 08/16/2008 RENEW OFC 014 AC
0
REMARICS RELEASE OF PERS0!AL INFO RESTRICTED.PAPER TITLE.
to Verify Ownership and Registration:
1. Check the title issue date. This date indicates the date title was
issued in the current owner’s name.
2. Check the current registration expiration date. If this date is in
the future, check the previous registration expiration date.
Registration is issued in 12 month increments.
How
7/28i2009
REQUEST FOR TEXAS MOTOR VEHICLE INFORMATION
of Transpo4aflon
VTR-275 (Rev. 12/2005)
DHT# 145635
I request that the Texas Department of Transportation (TxDOT), Vehicle Titles and Registration Division (VTR), furnish
me with the information specified below that is contained in the vehicle title and registration records for the vehicle
listed below.
Name of Requestor (Firm/Applicant)
Mailing Address
State
City
Zip Code
Daytime Phone
VEHICLE INFORMATION:
Current License Number
Expiration Year Of Plate
Year And Make Of Vehicle
Vehicle Identification Number
Title/Document Number
INFORMATION REQUESTED (Check the requested option):
OPTION 1. RECORD INQUIRIES:
Li
Li
Li
Title and registration verification of current motor vehicle record
Certified title and registration verification
Other (please describe the information requested)
$ 2.30
$ 3.30
Fees vary
THE DEPARTMENT MAY ONLY RELEASE THE INFORMATION REQUESTED ABOVE IF:
(Check one, if applicable)
Q (1) You are the subject (current recorded owner or lienholder) of the information contained in the record.
Q (2) You certify that the intended use of the requested information is for the permitted use(s) as indicated on the
back of this form. (If this option is chosen, back MUST be completed.)
Q (3) You have written authorization (MUST be attached) from a person named in the record (previous owner, owner
or lienholder) authorizing the department to release their personal information to you.
(NOTE: THE DEPARTMENT MAY ONLY RELEASE THE PERSONAL INFORMATION OF THE PERSON PROVIDING THE AUTHORIZATION.)
OPTION 2. TITLE HISTORIES (copies of Texas title transactions):
* THE DEPARTMENT MAY RELEASE A TITLE HISTORY ONLY if the intended use of the title history is for a permitted use as
indicated on the back. You MUST certify the permitted use(s) that applies to your request on the back of this form.
Li
U
Title history *
Certified title history *
$ 5.75
$ 6.75
IN MAKING THIS REQUEST, I CERTIFY THAT:
1.
2.
3.
4.
This information is requested for a lawful and legitimate purpose and will be used in accordance with 18 U.S.C., §2721-2725,
and Texas Transportation Code, Chapter 730;
If the information is requested for a permitted use(s), I will only use the information for that permitted use; and
The personal information obtained pursuant to this request will not be used for marketing, solicitation or survey purposes; and
I have not been convicted of a violation of Transportation Code, Chapter 730, or violated a rule adopted by TxDOT relating to
the terms and conditions for release of personal information from motor vehicle records.
I HEREBY CERTIFY THAT THE STATEMENTS CONTAINED HEREIN ARE TRUE AND CORRECT, TO THE BEST OF MY KNOWLEDGE.
SIGNATURE
CURRENT GOVERNMENT-ISSUED PHOTO IDENTIFICATION NUMBER
PRINTED NAME
STATE/AGENCY OF ID ISSUANCE
EXPIRATION DATE
(e.g., Driver’s license, DPS ID, Military ID, passport)
WARNING: VIOLATION OF THIS AGREEMENT IS A CLASS A MISDEMEANOR. Texas Transportation Code, Chapter 730, provides that a
person who makes a false statement or misrepresents their identity in order to obtain personal information from the department
records commits a Class A misdemeanor, punishable by a fine not to exceed $4,000, up to one year in jail or both.
This request must be submitted with cash, check cashiers check or money order in the amount indicated above. If you are mailing this request, cash is
discouraged. Please remit your request to any VTR Regional Office or mail directly to the VEHICLE TITLES AND REGISTRATION DIVISION, TEXAS
DEPARTMENT OF TRANSPORTATION, AUSTIN, TX 78779-0001.
PERMITTED USES
INITIAL (DO NOT CHECK I) ALL THAT APPLY IN THE SPACE PROVIDED:
USE OF THE REQUESTED PERSONAL INFORMATION WILL BE STRICTLY LIMITED TO:
Use by:
_(1) A government agency, including any court or law enforcement agency, in carrying out its functions; or
(2) A private person or entity acting on behalf of a government agency in carrying out the functions of the agency.
B.
Use in connection with any matter of:
(1) Motor vehicle or motor vehicle operator safety.
(2) Motor vehicle theft.
(3) Motor vehicle emissions.
(4) Motor vehicle product alterations, recalls or advisories.
(5) Performance monitoring of motor vehicles, motor vehicle parts or motor vehicle dealers.
(6) Motor vehicle market research activities, including survey research.
(7) Removal of non-owner records from the original owner records of a motor vehicle manufacturer to carry out
the purposes of the Automobile Information Disclosure Act, 15 U.S.C. §1231 et seq.: 49 U.S.C. Chapters 301,
305, 323, 325, 327, 329, and 331; the Anti Car Theft Act of 1992, 18 U.S.C. §553, 981, 982, 2119, 2312,
2313, and 2322, 19 U.S.C. §1646b and 1646c, and 42 U.S.C. §3750a et seq., all as amended; the Clean Air
Act, 42 U.S.C. §7401 et seq., as amended.
C.
Use in the normal course of business by a legitimate business or an authorized agent of the business, but only
to verify the accuracy of personal information submitted by the individual to the business or the agent of the
business; and if the information is not correct, to obtain the correct information, for the sole purpose of
preventing fraud by, pursuing a legal remedy against, or recovering on a debt or security interest against the
individual.
D.
Use:
_(1) In conjunction with a civil, criminal, administrative or arbitral proceeding in any court or government agency or
before any self-regulatory body, including service of process, investigation in anticipation of litigation,
execution or enforcement of a judgment or order, or under an order of any court; or
(2) For child support enforcement under Chapter 231, Family Code.
E.
Use in research or in producing statistical reports, but only if the personal information is not published,
redisclosed or used to contact any individual.
F.
Use by an insurer or insurance support organization, or by a self-insured entity, or an authorized agent of the
entity, in connection with claims investigation activities, antifraud activities, rating or underwriting.
G.
Use in providing notice to an owner of a towed or impounded vehicle.
H.
Use by a licensed private investigator agency or licensed security service for a purpose permitted under this
section.
I.
Use by an employer or an agent or insurer of the employer to obtain or verify information relating to a holder of
a commercial driver’s license that is required under 49 U.S.C. Chapter 313.
J.
Use in connection with the operation of a private toll transportation facility.
K.
Use for any other purpose specifically authorized by law that relates to the operation of a motor vehicle or to
A.
—
—
—
—
—
—
—
—
—
—
—
—
—
—
public safety.
Please cite the specific law:
RESALE and REDISCLOSURE:
A person obtaining motor vehicle record information for any of these permitted uses may resell or redisclose the
information only for these permitted uses, and must maintain records for a period of not less than 5 years of any
person or entity that received the information and the permitted use for which it was obtained. The purchaser must also
provide copies of those records to the department upon request. The information obtained as a result of this request may
not be resold or redisclosed in the identical or substantially identical format as it is received from the department.