Fillable Form 3019: ODOMETER DISCLOSURE STATEMENT INSTRUCTIONS ON REVERSE (Missouri)

Fill Online, Printable, Fillable, Blank Form 3019: ODOMETER DISCLOSURE STATEMENT INSTRUCTIONS ON REVERSE (Missouri) Form

Use Fill to complete blank online MISSOURI pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 3019: ODOMETER DISCLOSURE STATEMENT INSTRUCTIONS ON REVERSE (Missouri)

On average this form takes 13 minutes to complete

The Form 3019: ODOMETER DISCLOSURE STATEMENT INSTRUCTIONS ON REVERSE (Missouri) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 51 other fields

Country of origin: US
File type: PDF

BROWSE MISSOURI FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
MISSOURI DEPARTMENT OF REVENUE
MOTOR VEHICLE BUREAU
ODOMETER DISCLOSURE
STATEMENT
MO 860-2086 (01-2021)
FORM
3019
(REV. 01-2021)
Federal law (and State law, if applicable)
requires that you state the mileage
upon transfer of ownership. Failing
to complete or providing a false
statement may result in fines and/or
imprisonment.
INSTRUCTIONS ON REVERSE
YEAR MAKE VEHICLE IDENTIFICATION NUMBER
TITLE NUMBER STATE MODEL BODY STYLE
If purchaser/seller is an agent/officer of a firm, record official position after printed name. The purchaser/seller should
retain a copy of this odometer disclosure statement. If “Warning, Odometer Discrepancy” is checked, the seller must
attach a statement explaining all facts regarding the discrepancy.
PURCHASER(S) NAME DATE
(PRINTED OR TYPED)
ADDRESS
SELLER(S) (FIRM) NAME DEALER NO.
(PRINTED OR TYPED)
ADDRESS
ODOMETER READING
(NO TENTHS)
I state that the odometer now reads the aforementioned miles and to the
best of my knowledge that it reflects the actual mileage of the vehicle
described herein, unless one of the following statements is checked.
Mileage in excess of its mechanical limits
Mileage reading not actual
(WARNING, ODOMETER DISCREPANCY)
SIGNATURE OF PURCHASER(S) SIGNATURE OF SELLER(S)
HAND PRINTED NAME(S) BY PURCHASER(S) HAND PRINTED NAME(S) BY SELLER(S)
PURCHASER(S) NAME DATE
(PRINTED OR TYPED)
ADDRESS
SELLER(S) (FIRM) NAME DEALER NO.
(PRINTED OR TYPED)
ADDRESS
ODOMETER READING
(NO TENTHS)
I state that the odometer now reads the aforementioned miles and to the
best of my knowledge that it reflects the actual mileage of the vehicle
described herein, unless one of the following statements is checked.
Mileage in excess of its mechanical limits
Mileage reading not actual
(WARNING, ODOMETER DISCREPANCY)
SIGNATURE OF PURCHASER(S) SIGNATURE OF SELLER(S)
HAND PRINTED NAME(S) BY PURCHASER(S) HAND PRINTED NAME(S) BY SELLER(S)
PURCHASER(S) NAME DATE
(PRINTED OR TYPED)
ADDRESS
SELLER(S) (FIRM) NAME DEALER NO.
(PRINTED OR TYPED)
ADDRESS
ODOMETER READING
(NO TENTHS)
I state that the odometer now reads the aforementioned miles and to the
best of my knowledge that it reflects the actual mileage of the vehicle
described herein, unless one of the following statements is checked.
Mileage in excess of its mechanical limits
Mileage reading not actual
(WARNING, ODOMETER DISCREPANCY)
SIGNATURE OF PURCHASER(S) SIGNATURE OF SELLER(S)
HAND PRINTED NAME(S) BY PURCHASER(S) HAND PRINTED NAME(S) BY SELLER(S)
PURCHASER(S) NAME DATE
(PRINTED OR TYPED)
ADDRESS
SELLER(S) (FIRM) NAME DEALER NO.
(PRINTED OR TYPED)
ADDRESS
ODOMETER READING
(NO TENTHS)
I state that the odometer now reads the aforementioned miles and to the
best of my knowledge that it reflects the actual mileage of the vehicle
described herein, unless one of the following statements is checked.
Mileage in excess of its mechanical limits
Mileage reading not actual
(WARNING, ODOMETER DISCREPANCY)
SIGNATURE OF PURCHASER(S) SIGNATURE OF SELLER(S)
HAND PRINTED NAME(S) BY PURCHASER(S) HAND PRINTED NAME(S) BY SELLER(S)
Print
Reset
When a certificate of title or a manufacturer’s statement of origin does not meet the
federal requirements for a proper odometer disclosure, a separate odometer disclosure
statement must be issued by the seller and attached to the certificate of ownership at
the time of transfer of a motor vehicle.
The following vehicles are exempt from the odometer requirements:
1. Model year 2010 or older and at least ten years of age at the time of ownership
transfer;
2. Model year 2011 or newer and at least twenty years of age at the time of
ownership transfer;
3. Any motor vehicle having a gross vehicle weight rating of more than 16,000
pounds; and
4. Any new motor vehicle transferred from one franchise dealer to another.
If the Missouri title was issued after August 28, 1989, the odometer disclosure
is required to be completed on the back of the title rather than on a separate
disclosure statement.
COMPLETING THE ODOMETER DISCLOSURE STATEMENT
1. All information on the disclosure statement can be typed or computer generated
except for the printed names and signatures of the purchaser(s) and seller(s).
2. One purchaser and one seller must sign the form.
3. One purchaser and one seller must hand print their name.
4. The seller must state the exact mileage as listed on the odometer at the time of
transfer, excluding tenths. If there is a discrepancy in the number of miles shown, one
of the mileage blocks must be checked:
Mileage in Excess of Mechanical Limits — If the actual mileage of the vehicle is
125,000 but only 25,000 is shown on the odometer, the seller must insert 25,000
in the odometer reading area and check the box stating Mileage in Excess of
Mechanical Limits.
Mileage Reading Is Not Actual — If the true mileage is different from the mileage
shown on the odometer or the true mileage is unknown, the seller must submit a
statement explaining all facts concerning the true mileage versus the mileage shown
on the odometer.
MAKING CORRECTIONS ON ODOMETER DISCLOSURE STATEMENTS
If an error should occur when completing the second, third, or fourth odometer disclosure
space on the Odometer Disclosure Statement, the seller should:
1. Draw a large “X” in that disclosure space;
2. Make the correct disclosure in the next disclosure space;
3. Ensure that the purchaser and seller complete and sign a statement explaining the
error and attach it to the odometer disclosure statement.
NOTE: Both documents must accompany the application for title.
If the error is made while completing the fourth disclosure space, a new odometer
disclosure statement should be attached to the original disclosure statement,
accompanied by the statement explaining the error.
Web site address: www.dor.mo.gov/mvdl
MO 860-2086 (01-2021)
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 3019: ODOMETER DISCLOSURE STATEMENT INSTRUCTIONS ON REVERSE (Missouri)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 7 October 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document