(Seller’s Full Name)
(Address) (City)
(State) (Zip Code)
(Buyer’s Full Name)
(Address) (City)
(State) (Zip Code)
Vehicle Information
Model | Make | Year | Price | ||
Body Style | Color | Vehicle Identification Number (VIN) | |||
Vehicle Condition |
Federal and state law require the mileage of the vehicle to be provided upon transfer of ownership. Failure to complete this or providing a false statement may result in fines and/or imprisonment. I certify to the best of my knowledge that the vehicle’s odometer reading now reads: Miles.
Reflects the actual mileage of the vehicle described above
Reflects an amount of mileage in excess of its mechanical limits (odometer started over at zero) Does not reflect the actual mileage (WARNING – ODOMETER DISCREPANCY)
(Buyer's Name in Print) (Buyer’s Signature) (Date)
(Seller's Name in Print) (Seller’s Signature) (Date)
Keep this copy for your records
(Seller’s Full Name)
(Address) (City)
(State) (Zip Code)
(Buyer’s Full Name)
(Address) (City)
(State) (Zip Code)
Vehicle Information
Model | Make | Year | Price | ||
Body Style | Color | Vehicle Identification Number (VIN) | |||
Vehicle Condition |
Federal and state law require the mileage of the vehicle to be provided upon transfer of ownership. Failure to complete this or providing a false statement may result in fines and/or imprisonment. I certify to the best of my knowledge that the vehicle’s odometer reading now reads: Miles.
Reflects the actual mileage of the vehicle described above
Reflects an amount of mileage in excess of its mechanical limits (odometer started over at zero) Does not reflect the actual mileage (WARNING – ODOMETER DISCREPANCY)
(Buyer's Name in Print) (Buyer’s Signature) (Date)
(Seller's Name in Print) (Seller’s Signature) (Date)