BILL OF SALE
KNOW ALL MEN BY THESE PRESENTS:
That in consideration of ______________________________________________ Dollars ($ _______________ )
and other valuable consideration, the receipt whereof is hereby acknowledged, the undersigned (seller) does hereby sell,
transfer and deliver unto ______________________________________________________________________ (buyer),
his right, title and interest in and to the following described vehicle:
License Plate No. __________________ Vehicle Identication No. ___________________________________________
Make and Model Year ________________________________ Body Type _________________________
The said seller hereby warrants that he is the lawful owner of said vehicle; that it is free from all liens and
encumbrances except *lien in favor of _________________________________________________
_______________________________________________________________________________
Federal and state laws require that you state the mileage in connection with the transfer of ownership. Failure to
complete or providing a false statement may result in nes and/or imprisonment.
I certify that the odometer now reads ___________________________ (no tenths) and to the best of my knowledge that it
reects the actual mileage unless one of the following statements is checked:
o
(1) The odometer reading reects that amount of mileage in excess of its mechanical limits.
o
(2) The odometer reading is NOT the actual mileage. WARNING: ODOMETER DISCREPANCY.
Signed this ______ day of _________________ , 20 ____
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Signature of Seller
Printed Name of Seller
Signature of Seller
Address
Printed Name of Seller
City State Zip Code
Subscribed and sworn before me this _________ day
of _______________________________ ,20 _____ .
__________________________________________
State of Hawaii, _________________ Judicial Circuit
My commission expires: _________________
Notary Public
ADDRESS CITY STATE ZIP CODE
NAME
(Stamp or Seal) (Stamp or Seal)
CS-L(MVR)40 (Rev. 9/10)
*If no lienholder shown,
transfer will be processed
without recording lien.
NOTARY CERTIFICATION:
(Hawaii Administrative Rules §5-11-8)
Document Date: _________________ No. Pages: ______
Document Description: ____________________________
Notary Printed Name
Notary Signature Date
Circuit
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