Black Hills Federal Credit Union v. William Burris

IN THE DISTRICT COURT WITHIN AND FOR GARFIELD COUNTY STATE OF OKLAHOMA Black Hills Federal Credit Union, Plaintiff, vs. William Burris, Defendant. PETITION FOR REPLEVIN COMES NOW the Plaintiff, Black Hills Federal Credit Union, by and through its attorney, Collin M. Hinds, and for its cause of action against William Burris, alleges and states: 1. That the Plaintiff is duly authorized to do business within the State of Oklahoma. 2. That on the February 10, 2022, William Burris, for good and valuable consideration, made, executed and delivered a Contract and Security Agreement, in writing of that date, and promised to pay to the promisee, or its assigns the amount of the contract, and interest according to its terms and other things. A copy of said Contract is attached hereto, marked Exhibit "A", and made a part hereof, whereby said Defendant, whether one or more, became liable and bound to pay said sums therein specified to this Plaintiff, who is the holder and owner of said contract. 3. That as a part and parcel of the same transaction to secure the aforesaid indebtedness, Plaintiff was granted a security interest in the following described personal property, to-wit: 2022 Keystone Cougar, VIN: 4YDFCGM21NV503890. That said security interest was duly perfected. 4. That William Burris made default on said obligation by nonpayment according to its terms, the contract has been accelerated and there is now due and owing on the contract to the Plaintiff the amount of $80,281.85 with interest accruing. That due demand for payment has been made, and that William Burris refuse to pay the same. 5. That by virtue of said Security Agreement, the Plaintiff holds a lien upon, a special ownership in, and a right to immediate possession of the above-described personal property; and that said Defendants unlawfully and wrongfully withhold same from Plaintiff's possession. That due demand for the return of said property has been made by Plaintiff, but that the Defendants will not grant possession to Plaintiff. 6. Only for the purposes of establishing the amount of a pre-judgment delivery bond, if sought, the Plaintiff believes that said property has a value of $25,850.00. 7. The collateral has not been taken in execution or any order of judgment against said Plaintiff, or for the payment of any tax, fine or amercement aseed against them, or by virtue of an order of delivery issued, or any other means or final process issued against said Plaintiff. 8. As a result of the above said default by William Burris, the Plaintiff has been required to place this obligation in the hands of Hinds Law Firm, PC for legal proceedings and that pursuant to the terms of the contract, Plaintiff is entitled to a reasonable attorney fee. 9. Plaintiff hereby requests the issuance of an Order of Delivery for the recovery of the collateral and further requests that the Clerk of this Court issue a Notice to be served upon the debtors which notice shall notify that: (1) an Order of Delivery of the collateral is sought; (2) that the debtors have a right to object by written response filed with the Court Clerk and delivered or mailed to creditor's attorney within five days after service of the petition; and (3) the Order of Delivery shall be issued by the Clerk in the event no written response is filed within the five day period. 10. Pursuant to Title 15 U.S.C.A. §1692(g), Fair Debt Collection Practices Act, if applicable, unless the person or entity responsible for the payment of the above debt, within thirty days after receipt of this notice, disputes the validity of the debt, or any portion thereof, the debt will be assumed to be valid; and if said person or entity notifies the undersigned attorney for Plaintiff in writing within said thirty-day period that the debt, or any portion thereof, is disputed, said attorney will obtain verification of the debt and a copy of such verification will be mailed to said person or entity by the undersigned attorney for Plaintiff; and upon written request by you within the thirty-day period, undersigned attorney for Plaintiff will provide the name and address of the original creditor, if different from the current creditor. The law does not require me to wait until the end of the thirty-day period following first contact with you before suing you to collect the debt. Even though the law provides that your answer to the petition is to be filed in this action within 20-days you may obtain an extension of that time. Furthermore, no request will be made to the Court for a judgment until the expiration of thirty days after your receipt of this petition and summons. However, if, you request proof of the debt or the name and address of the original creditor within the thirty-day period that begins with your receipt of this petition and summons, the law requires me to cease my efforts (through litigation or otherwise) to collect the debt until I mail the requested information to you. You should consult an attorney for advice concerning your rights and obligations in this suit. This is a communication from a debt collector. This is an attempt to collect a debt and all information obtained will be used for that purpose. WHEREFORE, premises considered, Plaintiff prays that after due notice in accordance with the laws of the State of Oklahoma to the Defendants, that a Writ of Replevin be issued, granting immediate delivery of said property to Plaintiff, and that judgment be entered granting possession of said property to the Plaintiff, to be sold pursuant to the terms of the contract and the laws of the State of Oklahoma, that judgment be awarded against the Defendant, William Burris, in favor of the Plaintiff for a reasonable attorney fee, its costs of this action, and such other and further relief as the Court may in its judgment deem just and proper. Respectfully submitted, HINDS LAW FIRM, PC Attorneys for Plaintiff Collin M. Hinds, OBA # 17391 115 W. 3rd St., Ste. 410 Tulsa, OK 74103 (918) 514-3203 [email protected] STATE OF OKLAHOMA ) COUNTY OF TULSA ) ss. ) I, Collin M. Hinds, after being first duly sworn upon oath, depose and state: That I am the attorney for the Plaintiff in the above-entitled and numbered cause; that I have read the above Petition herein; that I know the contents thereof, and that the matters and things therein set forth are true and correct to the best of my knowledge. Collin M. Hinds Subscribed and sworn before me on this 11th day of March, 2026, by Collin M. Hinds. KEVIN GOETSHAKES FLINN Notary Public State of Oklahoma Commission #21003757 My Comm. Expires 3/18/2029 Notary Public Credit Application □ Credit Sale □ Lease Application Number: 7106047 Date: 02/10/2022 Seller Name and Address Camping World RV Sales - Rapid City 10400 Recreational Drive Summerset, SD 57718 The words "you" and "your" refer to each person or business submitting this Credit Application. The words "we," "us," and "our" refer to the seller and the financial companies to which your Credit Application is submitted. Important Information to Applicant(s). Federal law requires financial companies to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. What this means for you. When you apply for credit, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and federal law. Read each instruction carefully before completing this form. Type of Credit Requested Check only one of the three types: □ Individual Credit - You are relying on your income or assets. ☑ Joint Credit - By initialing below, you intend to apply for "joint credit". Applicant Joint Applicant Complete Section (B) Joint Applicant or Other Party if applicable. (A) Applicant FULL NAME (First, Middle, Last) LYANNA DIAZ GOV'T ID TYPE GOV'T ID NO. GOV'T ID ISSUED BY GOV'T ID ISSUE DATE GOV'T ID EXP. DATE DATE OF BIRTH SOC. SEC. NO. PRIMARY PHONE □ CELL SECOND PHONE □ CELL EMAIL ADDRESS: [email protected] STREET ADDRESS 14141 TELLURIDE ST APT# HOW LONG? 1 YEARS 6 MONTHS CITY SUMMERSET STATE SD ZIP 57769 MAILING ADDRESS (if different from Street Address) APT# MONTHLY RENT OR MORTGAGE PAYMENT $750.00 RESIDENTIAL STATUS □ OWN ☒ RENT □ WITH RELATIVES □ WITH FRIENDS □ OTHER LANDLORD/MORTGAGE LANDLORD PHONE 3955 POINTE WEST PL CITY RAPID CITY STATE SD ZIP 57702 HOW LONG? 2 YRS 0 MOS CURRENT EMPLOYER GROSS MONTHLY SALARY $5,600.00 CURRENT EMPLOYER'S ADDRESS CITY STATE ZIP WORK PHONE HOW LONG? OCCUPATION/JOB TITLE CLINICAL PSYCHOLOGIST 4 YRS 0 MOS GROSS MONTHLY SALARY PREVIOUS EMPLOYER (if less than 2 yrs at current job) PREVIOUS EMPLOYER'S FULL ADDRESS PHONE PREVIOUS EMPLOYER (if less than 2 yrs at current job) SECONDARY EMPLOYER NAME (if applicable) SECONDARY EMPLOYER ADDRESS CITY STATE ZIP GROSS MONTHLY SALARY SECONDARY EMPLOYER PHONE HOW LONG? OCCUPATION/JOB TITLE (B) Joint Applicant or Other Party FULL NAME (First, Middle, Last) WILLIAM BURRIS GOV'T ID TYPE GOV'T ID NO. GOV'T ID ISSUED BY GOV'T ID ISSUE DATE GOV'T ID EXP. DATE DATE OF BIRTH SOC. SEC. NO. PRIMARY PHONE □ CELL SECOND PHONE □ CELL EMAIL ADDRESS: CITY SUMMERSET STATE SD ZIP 57769 MAILING ADDRESS (if different from Street Address) APT# MONTHLY RENT OR MORTGAGE PAYMENT $750.00 RESIDENTIAL STATUS □ OWN ☒ RENT □ WITH RELATIVES □ WITH FRIENDS □ OTHER LANDLORD/MORTGAGE LANDLORD PHONE 3955 POINTE WEST PL CITY RAPID CITY STATE SD ZIP 57702 HOW LONG? 2 YRS 0 MOS CURRENT EMPLOYER GROSS MONTHLY SALARY $6,000.00 CURRENT EMPLOYER'S ADDRESS CITY STATE ZIP WORK PHONE HOW LONG? OCCUPATION/JOB TITLE LEAD OPERATOR 0 YRS 6 MOS GROSS MONTHLY SALARY PREVIOUS EMPLOYER (if less than 2 yrs at current job) PREVIOUS EMPLOYER'S FULL ADDRESS PHONE PREVIOUS EMPLOYER (if less than 2 yrs at current job) SECONDARY EMPLOYER NAME (if applicable) SECONDARY EMPLOYER ADDRESS CITY STATE ZIP GROSS MONTHLY SALARY SECONDARY EMPLOYER PHONE HOW LONG? OCCUPATION/JOB TITLE OTHER INCOME NOTE:* □ (A) or □ (B) GROSS MONTHLY OTHER INCOME OTHER INCOME SOURCE □ (A) or □ (B) GROSS MONTHLY OTHER INCOME OTHER INCOME SOURCE * Alimony, child support, or separate maintenance incomes do not have to be revealed unless the applicant wishes to have such sources considered as a basis for repayment of the requested credit amount. REFERENCE PHONE REFERENCE PHONE ADDRESS RELATIONSHIP ADDRESS RELATIONSHIP Notices California Residents. Each applicant, if married, may apply for a separate account. Maine Residents. You have the right to select the agent and insurer to be used for any type of insurance required in connection with this credit transaction, including the right to choose an insurance agent or broker, whether or not that agent or broker is affiliated with us. We shall not interfere, either directly or indirectly, with this right of choice of an agent and of an insurer. Your choice of a particular insurance agent or broker will not affect our credit decision or credit terms in any way, as long as the insurance provides adequate coverage with an insurer who meets our reasonable requirements such as the solvency and assessment policies of the insurer and its ability to service the policy. New Hampshire Residents. If this is an application for a balloon retail sales contract, applicants are entitled, upon request, to receive a written estimate of the monthly payment for a balloon payment refinancing in accordance with the creditor's current refinancing programs prior to entering into a balloon contract. New York Residents. A consumer report may be ordered in connection with your application. Upon your request, we will inform you whether or not a report was ordered. If a report was ordered, we will tell you the name and address of the consumer reporting agency that provided the report. Subsequent reports may be ordered or utilized in connection with an update, renewal or extension of credit for which you have applied. Ohio Residents. The 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. Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. Wisconsin Residents. Notice to Married Applicants. No provision of any marital property agreement, unilateral statement under Wisec. Statutes § 766.59 or a court decree under Wisec. Statutes § 766.70 adversely affects the interests of the Creditor unless the Creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the Creditor is incurred. For Married Wisconsin Residents. The credit being applied for, if granted, will be incurred in the interest of my marriage or family. I understand the Creditor may be required by law to give notice of this transaction to my spouse. Authorizations You authorize us to contact you using any of the telephone numbers listed on this Credit Application or that you subsequently provide us in connection with your credit account - regardless whether the number we use is assigned to a paging service, cellular telephone service, specialized mobile radio service, other radio common carrier service or any other service for which you may be charged for the call. You further authorize us to contact you through the use of voice, text and email and through the use of prerecorded/artificial voice messages or an automatic dialing device. You agree that your telephone communications with us and any financial company that reviews this Credit Application may be monitored and/or recorded to assure the quality of service. You authorize us to request one or more consumer reports, for any legitimate purpose, in connection with the transaction that is proposed by this Credit Application or any future update, renewal or extension of that transaction. This includes your authorization to check and verify information related to this Credit Application including, but not limited to, checking and verifying your credit, income and employment history, and contacting a spouse to verify any spouse-related information. You also authorize us to answer questions others may ask about our credit experience with you. You authorize us to submit this Credit Application and any other documents pertaining to this proposed transaction to the following financial company(ies): BLACK HILLS FEDERAL CREDIT UNION You authorize these companies and their affiliates to obtain any information they want in order to verify information related to this Credit Application including, but not limited to, verifying your credit, income and employment history, and contacting a spouse to verify any spouse-related information. [Signature] 2/10/2022 [Signature] 2/10/2022 Applicant's Signature Date Joint Applicant's or Other Party, Signature Date LYANNA DIAZ WILLIAM BURRIS Signatures You certify that everything you have stated in this Credit Application and on any other documents submitted to us are true and correct to the best of your knowledge. You understand that you must update the information contained in this Credit Application if either your financial condition materially changes or we make a request to you orally or in writing. You understand that we will retain this Credit Application whether or not it is approved. By signing below you acknowledge that you have read the applicable Notices and agree to the terms and authorizations in this Credit Application. [Signature] 2/10/2022 [Signature] 2/10/2022 Applicant Signature Date Joint Applicant or Other Party, Signature Date LYANNA DIAZ WILLIAM BURRIS (if applicable) Notice: It is a federal crime punishable by fine, imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code § 1001, et seq. For Seller Use Only DATE RECEIVED: 2/10/2022 RECEIVED BY: DATE ACTION TAKEN: ACTION TAKEN BY: ACTION TAKEN: REASON CODE(S): COLLATERAL 2022 COUGAR 27SGS FifthWheel 4YDFCGM21NV503890 TRADE-IN <table> <tr> <th>SELLING PRICE</th> <th>TRADE ALLOWANCE</th> <th>TRADE PAYOFF</th> <th>CASH DOWN</th> </tr> <tr> <td>$67,500.00</td> <td>$0.00</td> <td>$0.00</td> <td>$8,000.00</td> </tr> <tr> <th>PRODUCTS AND FEES</th> <th>AMOUNT FINANCED</th> <th>TERM</th> <th></th> </tr> <tr> <td>$0.00</td> <td>$59,500.00</td> <td>180 Months</td> <td>8.90%</td> </tr> </table> Credit Application Bankers Systems® ©2017 The Reynolds and Reynolds Company THERE ARE NO WARRANTIES, EXPRESS OR IMPLIED, AS TO CONTENT OR FITNESS FOR PURPOSE OF THIS FORM. CONSULT YOUR OWN LEGAL COUNSEL <table> <tr> <th>Post Date</th> <th>ID</th> <th>Eff Date</th> <th>Transaction</th> <th>Trans Amt</th> <th>Balance Chg</th> <th>Int/Pnity</th> <th>Fees</th> <th>New Balance</th> <th>Description</th> <th>Prev Available</th> </tr> <tr> <td>08/01/2025</td> <td>L 0400</td> <td>08/01/2025</td> <td>CPI ADDITION</td> <td></td> <td>6,439.00</td> <td></td> <td>0.00</td> <td>0.00</td> <td>70,857.50</td> <td>0.00</td> </tr> <tr> <td>08/15/2024</td> <td>L 0400</td> <td>08/15/2024</td> <td>Insurance Ad... Insurance Ad...</td> <td>3,674.00</td> <td>3,674.00</td> <td></td> <td>0.00</td> <td>0.00</td> <td>64,418.50 CPI Addon</td> <td>0.00</td> </tr> <tr> <td rowspan="3">07/05/2024</td> <td rowspan="3">L 0400</td> <td rowspan="3">07/05/2024</td> <td>%% PartialPmt %%% PartialPmt</td> <td>115.33 to 0.00</td> <td></td> <td></td> <td>0.00</td> <td>425.95</td> <td>60.14</td> <td>60,744.50</td> <td>0.00</td> </tr> <tr> <td>From DIAZ,LYANNA A 0002036839 Share 0020</td> <td>Transfer Pay...</td> <td>486.09</td> <td>0.00</td> <td></td> <td>0.00</td> <td></td> <td>0.00</td> </tr> <tr> <td>Internet Access 04/16/2024 13:40 359628</td> <td>%% PartialPmt</td> <td>113.33 to 115.33</td> <td></td> <td></td> <td></td> <td>0.00</td> <td></td> <td>60,744.50</td> <td></td> </tr> <tr> <td>04/16/2024</td> <td>L 0400</td> <td>04/16/2024</td> <td>From BURRIS,WILLIAM 0002036947 Share 0020</td> <td></td> <td>1,204.84</td> <td>-311.79</td> <td>862.98</td> <td>30.07</td> <td>60,744.50</td> <td>0.00</td> </tr> <tr> <td>02/09/2024</td> <td>L 0400</td> <td>02/09/2024</td> <td>Home Bankin... Internet Access 02/09/2024 20:45 357402</td> <td></td> <td>601.42</td> <td>-149.50</td> <td>451.92</td> <td>0.00</td> <td>61,056.29 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>01/05/2024</td> <td>L 0400</td> <td>01/05/2024</td> <td>Home Bankin... Internet Access 01/05/2024 13:39 859272</td> <td></td> <td>602.00</td> <td>-264.84</td> <td>337.16</td> <td>0.00</td> <td>61,205.79 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>12/10/2023</td> <td>L 0400</td> <td>12/10/2023</td> <td>Home Bankin... Internet Access 12/10/2023 11:14 487241</td> <td></td> <td>602.00</td> <td>-48.95</td> <td>553.05</td> <td>0.00</td> <td>61,470.63 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>11/10/2023</td> <td>L 0400</td> <td>11/10/2023</td> <td>Home Bankin... Internet Access 11/10/2023 09:22 593558</td> <td></td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>61,519.58 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>09/12/2023</td> <td>L 0400</td> <td>09/12/2023</td> <td>Home Bankin... Internet Access 09/12/2023 11:52 207157</td> <td></td> <td>615.14</td> <td>-459.33</td> <td>155.81</td> <td>0.00</td> <td>61,519.58 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>08/15/2023</td> <td>L 0400</td> <td>08/15/2023</td> <td>Home Bankin... Internet Access 08/05/2023 11:42 682181</td> <td></td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>61,978.91 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>05/31/2023</td> <td>L 0400</td> <td>05/31/2023</td> <td>Home Bankin... Internet Access 05/31/2023 12:34 751869</td> <td></td> <td>602.00</td> <td>-352.16</td> <td>249.84</td> <td>0.00</td> <td>61,978.91 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>05/12/2023</td> <td>L 0400</td> <td>05/12/2023</td> <td>Home Bankin... Internet Access 05/12/2023 08:22 500691</td> <td></td> <td>602.00</td> <td>-33.09</td> <td>568.91</td> <td>0.00</td> <td>62,331.07 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>04/07/2023</td> <td>L 0400</td> <td>04/07/2023</td> <td>Home Bankin... %% PartialPmt</td> <td>94.39 to 94.97</td> <td></td> <td></td> <td>0.00</td> <td>62,364.16 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>02/12/2023</td> <td>L 0400</td> <td>02/12/2023</td> <td>Home Bankin... Internet Access 02/12/2023 11:23 296666</td> <td></td> <td>602.00</td> <td>-509.15</td> <td>92.85</td> <td>0.00</td> <td>62,364.16 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>02/05/2023</td> <td>L 0400</td> <td>02/05/2023</td> <td>Home Bankin... Internet Access 02/05/2023 16:28 210663</td> <td></td> <td>601.42</td> <td>-281.67</td> <td>319.75</td> <td>0.00</td> <td>62,873.31 From Share 0020</td> <td>0.00</td> </tr> </table> <table> <tr> <th>Post Date</th> <th>ID</th> <th>Eff Date</th> <th>Transaction</th> <th>Trans Amt</th> <th>Balance Chg</th> <th>Int/Pnity</th> <th>Fees</th> <th>New Balance Description</th> <th>Prev Available</th> </tr> <tr> <td></td> <td></td> <td></td> <td>%% PartialPmt</td> <td>93.81</td> <td>94.39</td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>01/12/2023</td> <td>L 0400</td> <td>01/12/2023</td> <td>Internet Access 01/12/2023 11:23 895210<br>Home Bankin...</td> <td>602.00</td> <td>-187.76</td> <td>414.24</td> <td>0.00</td> <td>63,154.98 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>12/12/2022</td> <td>L 0400</td> <td>12/12/2022</td> <td>%% PartialPmt<br>Internet Access 12/12/2022 11:23 515344<br>Home Bankin...</td> <td>602.00</td> <td>-131.08</td> <td>470.92</td> <td>0.00</td> <td>63,342.74 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>11/12/2022</td> <td>L 0400</td> <td>11/12/2022</td> <td>%% PartialPmt<br>Internet Access 11/12/2022 11:23 152548<br>Home Bankin...</td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>63,473.82 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>10/14/2022</td> <td>L 0400</td> <td>10/14/2022</td> <td>%% PartialPmt<br>Internet Access 10/14/2022 13:03 800018<br>Home Bankin...</td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>63,473.82 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>09/14/2022</td> <td>L 0400</td> <td>09/14/2022</td> <td>%% PartialPmt<br>Internet Access 09/14/2022 18:52 429619<br>Home Bankin...</td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>63,473.82 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>08/11/2022</td> <td>L 0400</td> <td>08/11/2022</td> <td>%% PartialPmt<br>Internet Access 08/11/2022 11:39 17945<br>Home Bankin...</td> <td>602.00</td> <td>0.00</td> <td>602.00</td> <td>0.00</td> <td>63,473.82 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>05/11/2022</td> <td>L 0400</td> <td>05/11/2022</td> <td>%% PartialPmt<br>Internet Access 05/11/2022 10:19 926747<br>Home Bankin...</td> <td>602.00</td> <td>-199.03</td> <td>402.97</td> <td>0.00</td> <td>63,473.82 From Share 0020</td> <td>0.00</td> </tr> <tr> <td>04/11/2022</td> <td>L 0400</td> <td>04/11/2022</td> <td>Payment<br>CO: BLACK HILLS FCU NAME: 0002029438<br>TYPE: PAYMENT DATA: ELECTRONIC PAYMENT<br>TYPE: PAYMENT DATA: ELECTRONIC PAYMENT<br>601.42</td> <td>-170.43</td> <td>430.99</td> <td>0.00</td> <td>63,672.85 0002029438</td> <td>0.00</td> </tr> <tr> <td>03/10/2022</td> <td>L 0400</td> <td>03/10/2022</td> <td>Payment<br>Check Received 90.33<br>%% PartialPmt<br>Check Paym...</td> <td>601.42</td> <td>-222.99</td> <td>378.43</td> <td>0.00</td> <td>63,843.28 0002029438</td> <td>0.00</td> </tr> <tr> <td>02/15/2022</td> <td>L 0400</td> <td>02/15/2022</td> <td>Check Paym...<br>New Loan</td> <td>90.33</td> <td>64,089.00</td> <td>64,089.00</td> <td>0.00</td> <td>64,089.00</td> <td>0.00</td> </tr> </table> Retail Installment Contract and Security Agreement Retail Installment Contract and Security Agreement Seller Name and Address Buyer(s) Name(s) and Address(es) CONINGHAM WORLDS R.V. SALESIVE | JAYNA DAMS SUMMERSSET, SD 57918 14743 TSCOEUBID, SD SUMMERSSET, SD 57918 If this Contract is a consumer purpose Contract, then this Contract is consumer paper. Truth-In-Lending Disclosure Annual Percentage Rate The cost of your credit as a yearly rate 7.00% $64204.60 $64089.00 Finance Charge Amount Financed The dollar amount of credit you have received. $64089.00 Total of Payments The total of all payments you will make while repaying this obligation. $110255.60 Total Site Price The Total if payment for purchase at site plus any down payment of $0.00 $110255.60 Payment Schedule. Your payment schedule is: <table> <tr><th>No.</th><th>Due Date</th><th>Amount Due</th></tr> <tr><td>180</td><td>09/12/22</td><td>$601.82</td></tr> <tr><td>186</td><td>10/12/22</td><td>$601.82</td></tr> <tr><td>192</td><td>11/12/22</td><td>$601.82</td></tr> <tr><td colspan="2">MONTHLY BEGINNING: 03/12/22</td><td></td></tr> <tr><td colspan="2">MATURITY DATE: 02/12/32</td><td></td></tr> </table> Security. You are going as a co-owner interests in the property purchased. Late Charge. If payment is not made on due date, you will be charged a late charge of 5% of the payment due or $20, whichever is greater. Prepayment. If you pay off this Contract early, you will have to pay a penalty. Contract Protections. You can get the terms of this Contract and many additional information about repayment, default, any secured repayment before the scheduled date, and payment methods and protection. Description of Property <table> <tr> <th>Year</th> <th>Make</th> <th>Model</th> <th>#</th> <th>Vin</th> <th>Color</th> <th>Mileage</th> </tr> <tr> <td>2022</td> <td>Keystone</td> <td>Cougar</td> <td>275GS</td> <td>4YDFDCMK21XY503990</td> <td>Olive</td> <td>0</td> </tr> </table> Description of Trade-In [ ] Conditional Delivery. I declare, you agree that the following agreement regarding receiving delivery (applicable only): N/A The Agreement is part of the Contract. This Agreement is a major contract and a legal agreement. I acknowledge that if there are any omissions between the terms of the Agreement and the Contract, the terms of the Contract will apply. Termination of Amount Financed Cash Price (or Vehicle, etc.) (O.D. sales tax if applicable) N/A Trade-in Amount N/A Less Amount being paid to Seller N/A Other Down Payment (if any) N/A Down Payment (remaining) N/A Unpaid Balance of Cash Price (if any) N/A Financial Lease Amount (if any) N/A GAP Protection N/A Cost of Coverage on GAP Protection N/A Total Other Charges (Unpaid) Paid (if any) N/A Prepay Finance Charge N/A Amount Financed (Calc.) $64089.00 Amount Financed (Calculated) $64089.00 Insurance Disclosures Credit Insurance. Credit Life and Credit Disability insurance benefits are not provided by us and are not a feature in this contract. You will provide them directly if you qualify for coverage through your employer or other sources. If you do not qualify for such insurance, we will obtain it for you at your own expense. We are not able to offer any other comprehensive additional product. Product Description: Simple Term Life Premium N/A Term N/A Income N/A Credit Disability N/A Product Description: Simple Term Life Premium N/A Term N/A Insurance Amount N/A Your signature below means you want only the insurance coverage(ies) quoted above. If you desire to purchase any optional insurance coverage, you must request a separate proposal. Linda Wang 2/10/2022 By: [Signature] Date: [Date] Insurance Protection Coverage Description N/A Premium N/A Coverage Amount $1554.00 Coverage Amount N/A Term N/A Price $155.00 Coverage 2022 KEYSTONE COUGAR_275GS Coverage Amount Price N/A Coverage 2022 KEYSTONE COUGAR_275GS Additional Protections You may buy any of the following voluntary protection options. They are not required by law and are not guaranteed. Coverage will commence upon payment of premium and within the terms of said or related sale of the Vehicle. The voluntary protections will be provided in case you fail to agree to all associated costs. Your signature below means you want only the insurance coverage(ies) quoted above. If you desire to purchase any optional insurance coverage, you must request a separate proposal. by Linda Wang 2/10/2022 Date: Signature Notices The Annual Percentage Rate may be negotiable with the Seller. The Seller may assign this Contract and retain its right to receive a part of the Finance Charge. Signatures I have agreed. Your oral or written agreement is contained in this Contract. There is an agreement regarding this Contract. Any change to the Contract is made in writing and signed by both parties. Linda Wang 2/10/2022 By: [Signature] Date: Linda Wang 2/10/2022 By: [Signature] Date: Linda Wang 2/10/2022 By: [Signature] Date: [This space intentionally left blank.] Additional Terms of the Sales Agreement Definitions: "Contract" refers to this Retail Installation Contract and any Supplemental Agreement (the "Supplemental Agreement"). This contract includes all documents referenced herein by reference; all documents attached to this contract; and any related agreements between Purchaser and Seller. The term "Purchaser" means the individual named on this contract; "Retailer" means Seller; "Property" means the Vehicle, or the Property described in the Disclosure of Property section; "Deposit" means any deposit made by Purchaser and "Total Amount Due" refers to the total amount due by Purchaser for the Property after any deposit has been applied. Purchase of Property: You agree to purchase the Property hereunder, subject to the terms and conditions set forth herein. The price of the Property shall be paid as specified on the Vehicle receipt issued at the time of sale. General Terms. You agree to the following terms and conditions. By signing below, you acknowledge that you have received and read the following terms and conditions: 1) You understand that the property is being sold as is, where is, with no additional representations or warranties except as set forth above; 2) You understand that there may be a finance charge if you pay by credit card or check; and you will not agree to pay such finance charge; 3) You understand that the final payment for the Property is due within 60 days of the date of invoice; 4) You understand that if you fail to make any payment as required, the entire amount owed will be considered delinquent and you may be subject to late fees or repossession; 5) You understand that the Property is subject to recall, and may be recalled, if necessary; 6) You understand that the Property is subject to any applicable federal, state, and local laws, rules, and regulations; 7) You understand that the Property is subject to any applicable manufacturer's warranty; 8) You understand that the sale of the Property is subject to any applicable state and local taxes; Third Party Agreement In this section only, "you" refers only to the consumer signing this contract. By signing below, you acknowledge that you have received and read the information disclosed in the Disclosure of Property section. You also agree to the terms of the Contract including that you will use the Deposit to pay for the Property in accordance with the following schedule: [blank space] Date Assignment by Seller Seller sells and assigns, with respect to the Property, the Retail Installation Contract and Security Agreement, along with any attached instruments, if any, subject to the following conditions and limitations: This Assignment becomes effective upon receipt by Seller of written notice of assignment signed by Purchaser. No new financing arrangements shall be made without the approval of Seller. The Assignment shall be made in good faith and without fraud, duress, or unconscionability. The Assignment shall not be made until the contract payments have been received in full. The Assignment shall not be made until the contract payments have been received in full, except in cases where the contract payments have been received in full, but the title of the Property has not yet passed to Purchaser. The Assignment shall not be made until the contract payments have been received in full, except in cases where the contract payments have been received in full, but the title of the Property has not yet passed to Purchaser. The Assignment shall not be made until the contract payments have been received in full, except in cases where the contract payments have been received in full, but the title of the Property has not yet passed to Purchaser. Security Agreement Safety and Security Program. The safety and security program offered by Seller is optional and does not replace any existing security program. The program provides protection against unauthorized use of the Property while it is in Seller's possession, and is subject to the terms and conditions set forth herein. Participation in the program requires the completion of an application form and the payment of a security fee. Seller reserves the right to refuse participation in the program and to terminate the program at any time. Disclaimer of Liability, Indemnity, and Release. Seller disclaims all liability for any loss, damage, or injury sustained by Purchaser or any other person arising out of or related to the sale, delivery, operation, or use of the Property. Seller assumes no liability for any losses, damages, or injuries sustained by Purchaser or any other person arising out of or related to the sale, delivery, operation, or use of the Property. Seller will not be held liable for any losses, damages, or injuries sustained by Purchaser or any other person arising out of or related to the sale, delivery, operation, or use of the Property. Disclaimer of Representations and Warranties. Seller makes no representations or warranties, express or implied, regarding the Property, including but not limited to, the fitness for purpose, merchantability, or any warranty of title. Seller makes no representations or warranties regarding the condition of the Property, the accuracy of any description or information concerning the Property, or the performance of the Property under normal operating conditions. Disclaimer of Consequential Damages. In no event will Seller be liable for any special, indirect, incidental, or consequential damages of any kind, whether based on breach of contract, negligence or otherwise, even if Seller has been advised of the possibility of such damages. Disclaimer of Liability for Delay. Seller shall not be responsible for any delay in delivery of the Property due to causes beyond Seller's control. Disclaimer of Warranty. Seller makes no representations or warranties regarding the warranty period for the Property, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Title. Seller makes no representations or warranties regarding the warranty of title for the Property, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Conformity to Description. Seller makes no representations or warranties regarding the conformity of the Property to any description or information provided by Seller, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Fitness for Purpose. Seller makes no representations or warranties regarding the fitness for purpose of the Property, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Merchantability. Seller makes no representations or warranties regarding the merchantability of the Property, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Accuracy of Information. Seller makes no representations or warranties regarding the accuracy of any description or information provided by Seller, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Non-Infringement. Seller makes no representations or warranties regarding the non-infringement of any patent, trademark, or copyright by the Property, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Applicability. Seller makes no representations or warranties regarding the applicability of any description or information provided by Seller, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Laws. Seller makes no representations or warranties regarding the compliance of the Property with any law, statute, ordinance, rule, regulation, or other authority, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Specifications. Seller makes no representations or warranties regarding the compliance of the Property with any specification, requirement, or other authority, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Intended Use. Seller makes no representations or warranties regarding the compliance of the Property with any intended use, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Environmental Regulations. Seller makes no representations or warranties regarding the compliance of the Property with any environmental regulation, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Safety Regulations. Seller makes no representations or warranties regarding the compliance of the Property with any safety regulation, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Legal Requirements. Seller makes no representations or warranties regarding the compliance of the Property with any legal requirement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Ordinance. Seller makes no representations or warranties regarding the compliance of the Property with any ordinance, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Procedure. Seller makes no representations or warranties regarding the compliance of the Property with any administrative procedure, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the Property with any administrative order, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Notice. Seller makes no representations or warranties regarding the compliance of the Property with any administrative notice, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Announcement. Seller makes no representations or warranties regarding the compliance of the Property with any administrative announcement, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Decision. Seller makes no representations or warranties regarding the compliance of the Property with any administrative decision, or any extension thereof, except as specifically provided herein. Disclaimer of Warranty of Compliance with Administrative Order. Seller makes no representations or warranties regarding the compliance of the DDI Technology Premier eTitleLien® Electronic Title Copy Vehicle ID Number 4YDFCGM21NV503890 Year 2022 Make KEYS Model 8X30 C Body Style TRAILE Lic Plate Reg Exp Weight New/Used Vehicle Color Odometer [0]* State SD Date Issued 05-10-2022 Title Number 220470172 CLEAR Full Name of Owner(s) LYANNA DIAZ WILLIAM BURRIS 14141 TELLURIDE STREET SUMMERSET, SD 57769 Liens(s) BLACK HILLS FCU [PO Box 1420 Rapid City, SD 57709]* Lien Date: 02-16-2022 ELT Number: 46023552901 LTN: 2029438-0400 * Information has been supplied by the lienholder, not the state titling agency. Document ID: TQZFUAGO57 THIS IS NOT A TITLE This is an official Premier eTitleLien® Report generated by a customer of DDI Technology.