Odometer Disclosure Form
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Effective Date: ____/____/______
Buyer [Legal Name] (AKA, "The Buyer")
Located [City], [State] [Zip Code]
&
Seller [Legal Name](AKA, "The Seller")
Located at [Address]
[City], [State] [Zip Code]
I the Seller do hereby state that the odometer mileage as indicated for the below described vehicle is in the following:
[__] Miles [__] Kilometers [__] Hours
To the best of my knowledge, I do hereby certify that:
[__] The odometer reading is the actual logged mileage.
[__] The odometer reading is an amount of mileage that is beyond its mechanical limits.
[__] The odometer reading is not the actual mileage that has been used.
Year:
________________________________
Make:
________________________________
Model:
________________________________
Body Type:
________________________________
VIN:
________________________________
Applicable Law
This contract shall be governed by the laws of the State of ____ in _____ County and any applicable Federal Law.
________________________________
Signature of The Buyer
________________________________
Signature of The Seller
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