RELEASE OF LIABILITY FORM

I Walter Enrique Morales Villalobos, hereby agree to be responsible for

titling and registering the 2022 Husqvarna FS 450 with VIN#
VBKUSR437NM358554 in the country of Costa Rica. I release
Powersports of Palm Beach from any liability and/or penalties that may
arise from the titling and registration not being done timely or properly.
Powersports of Palm Beach will provide the following documents in
order for the motorcycle to be registered:
1) Bill of Sale
2) Warranty Disclaimer
3) Odometer Statement
4) Title
Powersports of Palm Beach will send these documents via Fedex 2-Day,
once we have received cleared payment. Once the documents have
been sent that will end Powersports of Palm Beach’s obligations.

____________________ ______________
06/25/2024

Walter Enrique Morales Villalobos Date

(Buyer)

____________________ _______________
06/25/2024

Powersports of Palm Beach Date

(Seller)
 Date
06/25/2024

Deal #
3796

Salesperson
1422 10th St. Lake Park FL 33403 Steve Goldberg
(561) 844-2102
Buyer:Morales Villalobos, Walter Enrique Co-Buyer:
300m S & 10m E of Natl Bank Casa 43
., San Jose, Costa Rica .
(786) 342-0243 (786) 342-0243
[email protected]
Major Unit:
Stock # Year Make Model VIN# Color DSP
HUS358554 2022 Husqvarna FS 450 VBKUSR437NM358554 White / Yellow 8,330.00

Lien Holder:
Trade-In:
Stock # Year Make Model Vin # Allowance Pay-Off

$8,330.00
$0.00
$0.00
$75.00
$8,405.00
$0.00
$0.00
$0.00
$0.00
Payments $0.00
Zelle $500.00 06/21/2024 $0.00
Wire $7,975.00 06/25/2024
$400.00 $0.00
Wire 06/25/2024
Zelle $25.00 06/25/2024 $0.00
$0.00
$0.00
$495.00
Buyer: __________________________________ Date: ________
06/25/2024 $0.00
$8,900.00

Co-Buyer: __________________________________ Date: ________

06/25/2024
$0.00
Dealer: __________________________________ Date: ________
06/25/2024 $8,900.00
$0.00
www.561powersports.com
 WARRANTY DISCLAIMER

Customer Name:__________________________________________ Vehicle Stock Number:_______________________

Customer Name:__________________________________________
Date:___________________________

Vehicle Information Vehicle Type: Motor Vehicle Mobile Home Vessel

Year:___________ Make/Model:____________________________ Color:________________ Body:_______________

Title No.:____________________ VIN: ________________________________________

The checked items apply.

The vehicle is NEW. ANY WARRANTY THAT WOULD APPLY, WOULD BE PROVIDED BY THE MANUFACTURER. DEALER
PROVIDES NO WARRANTIES.

If the vehicle has dealer installed equipment, this equipment will not be covered by the manufacturer’s warranty.
ANY WARRANTY THAT WOULD APPLY, IF ANY, WOULD BE PROVIDED BY THE MANUFACTURER OF SUCH EQUIPMENT.
DEALER PROVIDES NO WARRANTIES.

The vehicle is USED. The above referenced motor vehicle is sold “AS IS” WITH ALL FAULTS. “AS IS” means that
dealer is not providing any warranties whatsoever with regard to the vehicle. Customer accepts the vehicle in its
present condition, in spite of any present or future defects, and understands and accepts that dealer is not required
to make any repairs after the Customer has purchased the vehicle. Customer will be responsible for any and all
repairs.

DEALER HEREBY EXPRESSLY DISCLAIMS ANY AND ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING
IMPLIED WARRANTIES OF MERCHANTABILITY AND/OR FITNESS FOR A PARTICULAR PURPOSE. To the
extent not prohibited by law, dealer shall not be liable for damages relating to loss of use, loss of time,
inconvenience or commercial loss, or any other incidental or consequential damages. SOME STATES DO NOT ALLOW
LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY LASTS OR EXCLUSIONS OR LIMITATIONS ON RELIEF SUCH AS
INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO LIMITATIONS MAY NOT APPLY TO YOU. THIS WARRANTY GIVES
YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS WHICH VARY FROM STATE TO STATE. Prior
written or oral statements, negotiations, communications or representations regarding warranties have been
merged into or superseded by this document, and if not included, are not binding on dealer. No person is
authorized to give any warranties on the vehicle on behalf of dealer. This is the total agreement about any and all
warranties on the vehicle. This Warranty Disclaimer is a part of the Buyer’s Order, and as such is supplemented by
the Buyer’s Guide.

If any part of this Warranty Disclaimer is prohibited, declared unconscionable or otherwise unenforceable (wholly or
partially), such part shall be removed and of no effect. However, the remainder of the Warranty Disclaimer, to the
extent legal and permissible, shall not be affected and will continue to be enforced.

Name of Dealer: _________________________________________

_____________________________________________ _____________________________________________
Customer Signature Customer Signature

Copyright © 2011, Title Technologies, Inc. All rights reserved.

The printer of this form makes no warranty, express or implied, as to content or fitness for purpose of this form. Pleases consult your legal counsel.
 STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
www.flhsmv.gov/offices/

SEPARATE ODOMETER DISCLOSURE STATEMENT AND ACKNOWLEDGMENT

VEHICLE DESCRIPTION
Vehicle Identification Number Year Make Color Body Title Number

ODOMETER DISCLOSURE STATEMENT

WARNING: Federal and State law requires that you state the mileage in connection with an application for a
Certificate of Title. Failure to complete or providing a false statement may result in fines and/or imprisonment.

WE STATE THAT THIS 5 or 6 DIGIT ODOMETER NOW READS , .XX (NO TENTHS) MILES,
DATE READ ________/_______/________, AND WE HEREBY CERTIFY THAT TO THE BEST OF OUR KNOWLEDGE THE
ODOMETER READING:
1. REFLECTS ACTUAL MILEAGE.
CAUTION:
Read carefully before 2. IS IN EXCESS OF ITS MECHANICAL LIMITS.(EXCESS OF ITS MECHANICAL LIMITS APPLIES TO 5 DIGIT ODOMETERS)
checking a box.
3. IS NOT THE ACTUAL MILEAGE. WARNING – ODOMETER DISCREPANCY

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.

Seller’s Signature Seller’s Printed Name

Seller’s Street Address

City State Zip

Buyer’s Signature Buyer’s Printed Name

Buyer’s Street Address

City State Zip

WHO IS AUTHORIZED TO COMPLETE THIS FORM?

ANY PERSON WHO IS BUYING OR SELLING A MOTOR VEHICLE AND WHO MUST MAKE OR ACKNOWLEDGE AN ODOMETER
DISCLOSURE, IN ORDER TO COMPLY WITH STATE OR FEDERAL ODOMETER DISCLOSURE LAW.
WHEN SHOULD THIS FORM BE USED?
1. WHEN A MOTOR VEHICLE, FOR WHICH AN ODOMETER DISCLOSURE IS REQUIRED, HAS BEEN SOLD.
2. WHEN A MOTOR VEHICLE, FOR WHICH AN ODOMETER DISCLOSURE IS REQUIRED, HAS BEEN PURCHASED.
3. WHEN AN ODOMETER DISCLOSURE STATEMENT AND ACKNOWLEDGMENT BETWEEN THE BUYER AND THE SELLER IS
REQUIRED, BUT NO ODOMETER DISCLOSURE STATEMENT HAS BEEN MADE ON ANOTHER STATE OR FEDERAL FORM.
WHEN SHOULD THIS FORM NOT BE USED?
1. WHEN A FLORIDA TITLE WHICH WAS ISSUED ON OR AFTER APRIL 29, 1990 IS AVAILABLE.
2. WHEN A FORM HSMV 82994, MOTOR VEHICLE DEALER TITLE REASSIGNMENT SUPPLEMENT, HAS BEEN USED.
3. WHEN A FORM HSMV 82995, MOTOR VEHICLE DEALER POWER OF ATTORNEY/ODOMETER DISCLOSURE, HAS BEEN USED.
4. WHEN AN OUT-OF-STATE TITLE, WHICH CONFORMS TO FEDERAL LAW, IS USED TO TRANSFER A MOTOR VEHICLE.
FILING:
1. COPIES SHOULD BE EXCHANGED BETWEEN THE SELLER AND THE BUYER. DEALERS MUST RETAIN THIS DOCUMENT IN THEIR
RECORDS FOR A PERIOD OF FIVE YEARS.
2. IT IS NOT NECESSARY TO FILE THIS FORM OR ANY COPY OF THIS FORM WITH THE STATE OF FLORIDA, UNLESS REQUESTED TO
DO SO BY THE DIVISION OF MOTOR E ICES.

Check your local phone book government pages or visit the following website for current mailing addresses: http://www.flhsmv.gov/offices/

HSMV 82993 (REV. 11/11)

 STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES - DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
www.flhsmv.gov/ offices/

Notice of Sale and/or Bill of Sale for a Motor Vehicle,

Mobile Home, Off-Highway Vehicle or Vessel
Notice of Sale (Seller must complete sections 1 & 3). The purchaser’s signature in section 3 is optional.
Bill of Sale (Seller and purchaser must complete sections 1, 2 (when applicable) & 3).
1. Motor Vehicle, Mobile Home, Off- Highway or Vessel Description
Year Make/Manufacturer Body Type Model Color

Certificate of Title Number Current Title Issue Date Vehicle/Vessel Identification Number

I/we do hereby sell or have sold and delivered the above described motor vehicle, mobile home,
off-highway vehicle or vessel to:
Print Name(s) of Purchaser(s)

Address City State Zip Code

Date of Sale Selling price

$
2. Odometer Disclosure Statement (Required For a Motor Vehicle)
Federal and State law requires that you state the mileage in connection with the transfer of ownership. Failure to
complete or providing a false statement may result in fines and/or imprisonment.
WE STATE THAT THIS MOTOR VEHICLE’S 5 DIGIT OR 6 DIGIT ODOMETER NOW READS , . xx
(NO TENTHS) MILES, DATE READ ________/________/________, AND WE HEREBY CERTIFY THAT TO THE BEST OF OUR KNOWLEDGE
THE ODOMETER READING:
1. REFLECTS THE ACTUAL MILEAGE. 2. IS IN EXCESS OF ITS MECHANICAL LIMITS. 3. IS NOT THE ACTUAL MILEAGE.

Affidavit (When applicable):

3. Certification
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS
STATED IN IT ARE TRUE.
Seller's Signature Seller's Printed Name Date

Seller's Address City State Zip Code

Co-Seller's Signature (when applicable) Co-Seller's Printed Name (when applicable) Date

Co-Seller's Address (when applicable) City State Zip Code

Purchaser's Signature Purchaser's Printed Name Date

Co-Purchaser's Signature (when applicable) Co-Purchaser's Printed name (when applicable) Date

OWNERSHIP STATUS FOR THE ABOVE DESCRIBED MOTOR VEHICLE, MOBILE HOME, OFF-HIGHWAY VEHICLE OR VESSEL
WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
Check your local phone book government pages or visit the following website for current mailing addresses: http:/ / www.flhsmv.gov/ offices/
HSMV 82050 (Rev. 03/21) S