OBL315 (10/2011)
Business Name Business License Number
Vehicle Year: Vehicle Make: Vehicle Model:
Number of Payments Number of Payments
Monthly Payment:
(including sales tax)
Monthly Payment:
(including sales tax)
Annual Percentage Rate Annual Percentage Rate
Total Finance Charge Total Finance Charge
Total Sales Price Total Sales Price
Vehicle Year: Vehicle Make: Vehicle Model:
Compliance Enforcement Division
555 Wright Way
Carson City, NV 89711-0900
(775) 684-4790
www.dmvnv.com
DISCLOSURE FORM
NOTICE TO PURCHASER: Nevada State Law requires the use of a disclosure form whenever a seller of a vehicle exercises a
valid option to cancel the sale of a vehicle. The seller must provide a disclosure form, and the customer must sign the disclosure
form, before the seller and customer may enter into a new agreement for the sale of the same vehicle on different terms, or for
the sale of a different vehicle.
YOU ARE NOT OBLIGATED TO PROCEED WITH PURCHASING THE SAME VEHICLE UNDER DIFFERENT TERMS OR TO
PURCHASE A DIFFERENT VEHICLE. YOU MAY RETURN THE VEHICLE, PROVIDING NO DAMAGE TO THE VEHICLE HAS
OCCURRED SINCE RECEIPT OF THE VEHICLE, OTHER THAN REASONABLE WEAR AND TEAR. THE SELLER MUST
RETURN ANY DOWN PAYMENT OR OTHER CONSIDERATION IN FULL, INCLUDING, RETURNING A VEHICLE
ACCEPTED IN TRADE.
SECTION 1: TO BE COMPLETED BY SELLER
Business Mailing Address:
Street City State Zip
SAME VEHICLE SALE INFORMATION
To be completed when the same vehicle is being sold under new sale terms.
Vehicle Identification Number:
INITIAL TERMS REVISED TERMS
SECOND VEHICLE SALE INFORMATION
To be completed for a second vehicle when the initial vehicle is returned.
Vehicle Identification Number:
Number of Payments:
Monthly Payment:
(Including Sales Tax)
Annual Percentage Rate:
Total Finance Charge:
Total Sales Price:
SECTION 2: TO BE COMPLETED BY BUYER
Buyer’s Name:
Buyer’s Mailing Address:
Street City State Zip
Buyer's Physical Address:
Street City State Zip
Telephone Number: ( ) -
E-Mail Address:
AGREEMENT TO ACCEPTANCE OF SELLER’S TERMS FOUND IN SECTION 1
I, accept the terms found in Section 1 of this disclosure form and understand:
Initial
a. That Nevada State Law does not require me to accept the vehicle initially delivered
to me under different terms as initially agreed to, or to accept a different vehicle.
b. That I may return the vehicle delivered to me and receive my down payment or other
consideration, including my trade in vehicle, providing the vehicle delivered to me has
not been damaged other than normal wear and tear.
Signature of Buyer: Date:
