KANSAS
DEPARTMENT OF REVENUE
DIVISION OF VEHICLES
www.ksrevenue.org
AFFIDAVIT OF PURCHASE PRICE
Must be fully completed
This Affidavit of Purchase Price is to certify the amount of money or value that was exchange between the seller(s) and buyer(s) for the
vehicle listed herein.
ONLY antique vehicles (vehicle 35 years old or older) owned by a Kansas resident and located in the State of Kansas can have the
ownership transferred (sold) by completing the Antique Vehicle Transfer of Ownership at the bottom of this form. All other vehicles sold by
or purchased from a Kansas resident must have the ownership transferred (sold) by assigned title.
SELLER'S BUYER’S
Printed Name: Printed Name:
Address: Address:
City: City:
State: State:
ZIP : ZIP :
VEHICLE INFORMATION:
Year Make
VIN
Purchase Price: $ Date of Sale:
By our signatures, we swear and affirm the above stated purchase price is true and accurate under penalty of perjury. I am
aware that the law provides severe penalties for making false statements under oath.
Signature of Seller: Date:
Signature of Buyer: Date:
ANTIQUE VEHICLE TRANSFER OF OWNERSHIP
This section of the bill of sale is to be used to transfer ownership of an antique vehicle (vehicle that is 35 model years old or older) when
there is no Kansas title for the vehicle in the name of the owner/seller. All information in the bill of sale above and the antique vehicle
transfer of ownership below MUST be complete for this to be a valid assignment of ownership.
If a non-Kansas resident owns the antique vehicle and the vehicle is not maintained/garaged in Kansas, the ownership of the vehicle must
be transferred according to the laws of the seller’s home state of residence.
I, the undersigned, certify that I am the owner of this antique vehicle, which is listed above, and on this day I have sold and
am transferring ownership of this vehicle to listed above as buyer.
To the best of my knowledge, no title has been issued in my name for this vehicle in any titling jurisdiction.
I further certify that I will guarantee this vehicle to be free and clear from all defects, liens or encumbrances of any nature
whatsoever and that I will indemnify any subsequent purchaser of same for any loss sustained should anyone prove ownership
of said vehicle superior to my title.
Date vehicle was Signature
sold and delivered:
Month Day Year of Seller:
NOTICE TO BUYER: All 1950 or newer antique vehicles sold on a bill of sale must obtain an MVE-1, (Motor Vehicle Examination)
issued by the Kansas Highway Patrol or their designee and submit the MVE-1 with this bill of sale when applying
for antique title. Application for title must be made within 30 days of the purchase date in the county treasurer’s
motor vehicle office in the county in which the vehicle will be located/garaged. Penalty will be assessed on and
after the 31
st
day.
TR-11www (New 03/05)
