TITLEMAX OF GEORGIA, d/b/a TITLEMAX

VEHICLE RELEASE FORM

Titlemax of Georgia, d/b/a Titlemax, hereby authorizes and directs the independent third party
Insurance Auto Auction, to release the vehicle referenced below to __NELSON NDUKWE_.
a Titiemax customer. Before releasing the vehicle, Insurance Auto Auction agrees to verity the
customer's identity by reviewing the customer's driver's license or state/government issued
photo identification.

AL
Insurance Auto Auction agrees that all payments for its services, including but not limited to, storage
and towing services, are solely the responsibility of Titlemax. In exchange for payment by Titlemax to Insurance Auto
Auction for all services rendered, insurance Auto Auction agrees to release the below

TI
vehicle to _NELSON NDUKWE free and clear of any costs, charges, liens, fees and payment of
any kind that may have accrued to insurance Auto Auction during the course of this transaction.

License Plate:
Year/Make/Model :  2008/NISSAN/PATHFINDER
EN
Color: Black
VIN: 5N1AR18U88C659523
Stock#
D
FI

Insurance auto
Auction
Atlanta North
6242 Black
N

Acre Trail NW
Acworth, GA
30101
(770) 975-1107
O
C

Insurance Auto Auction acknowledges that upon signing this form, it shall not attempt to collect
any monies from Titlemax customer or from any other source other than Titlemax for the services
provided in this transaction.

TITLEMAX INSUARANCE AUTO AUCTION

Signature Signature

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