Buyer Receipt

Receipt # 17992032
Receipt Date 12/24/2021
Received By ASAP S
Sold At Branch 521 - Milwaukee
Paid At:
999 - Corporate Sale Date 12/21/2021
Two Westbrook Corporate Center Suite 500
Buyer # 70000
Westchester IL 60154
(708) 492-7000 Buyer Name GUATEXAS AUTO SALES
Branch Dealer # : Dealer
Branch Tax # : 4351040
Resale Certificate # 3-20204-1888-8
Registration Expires 10/28/2022

Sale License
StockNo Item # Year Make Model Color Mileage VIN Plate #
000-31886503 A-0078 2008 MITSUBIS OUTLANDER White 164,837 JA4LT31W88Z019566

Invoice To: Description Charges Payments Balance

Bid Amount $500.00
GUATEXAS AUTO SALES Buyer Fee $125.00
Service Fee $59.00
8606 New Laredo Hwy Internet Fee $49.00

San Antonio, TX. 78211

Check # / Reference No.

I-Payment - $733.00
2908359-101220035576

Total Payment $733.00

Amount: 12/24/2021 12:04:40 AM - Payment $733.00
Remaining Amount Due $0.00

PAID IN FULL Total $733.00 $733.00 $0.00

Special Notes:

For Exporter Use Tax ID: 953790111 A wholly owned subsidiary of affiliate of Insurance Auto Auctions, Inc., Registrant #008 - FEIN
95-3790111

Receipt Acknowledged by:

Print Name/Company/Title

Buyer Signature IAA Signature

<IAAI BRE 62429763 BUYERRECG>
Seller Signature Date
IAA Doc: RP018.00 2/28/2022 1:14:17 PM Page 1 of 1