Odometer Mileage Statement

IMPORTANT: Federal regulations require this statement to be given to purchasers on sales of vehicles. An inaccurate or untrue statement may make you liable for damages to the buyer and there may also be civil or criminal penalties.

______________________, state that the odometer described below now reads _____________.

Certify one of the followingplease â€œXXXâ€ the appropriate line before the correct statement:

___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the actual mileage of the vehicle described below.

___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the amount of mileage in excess of designed mechanical limits of 99,999 miles of the vehicle described below.

___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above is NOT the actual mileage of the vehicle described below, and should not be relied upon.

MAKE: ____________

MODEL ____________

BODY TYPE ________

YEAR: ____________

VEHICLE IDENTIFICATION NUMBER: __________________

Certify one of the followingplease â€œXXXâ€ the appropriate line before the correct statement:

__________ I (we) certify that the odometer of the vehicle described above was not altered, set back, or disconnected while in my (our) possession, and I (we) have no knowledge of anyone else doing so.

__________ I (we) certify that the odometer was alerted for repair or replacement purposes while in my (our) possession, and that the mileage registered on the repaired or replaced odometer is identical to that before such service.

__________ I (we) certify that if the repaired or replacement odometer was incapable of registering the same mileage, that it was reset to zero, and that the mileage on the original odometer or the odometer before repair was __________________ miles.

SELLER (Transferor) address:

____________________________________

Date of statement: ___________________________

___________________________________________________

BUYER (Transferee) name and address:

____________________________________________________

Receipt of copy acknowledged by Buyer:

____________________________________________

Odometer Mileage Statement

Review List

This review list is provided to inform you about this document in question and assist you in its preparation. Federal and most states require an odometer mileage statement when a used car or other similar vehicle is sold. Be accurate. Getting caught up in misrepresentations is not worth the hassle of being prosecuted vigorously by your local Attorney Generals office or by a Plaintiffs attorney on behalf of the Buyer. Courts tend to be very much prejudiced in favor of the buyer of used carsso be duly cautioned.

1. Make multiple copies. Give one to each signatory. Keep one with the transaction file.

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