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Complete Home & Office Legal Guide
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Complete Home and Office Legal Guide (Chestnut) (1993).ISO
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1993-08-01
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103 lines
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 following-- please "XXX" 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 following-- please "XXX" 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:
____________________________________________