Motor Vehicle Bill of Sale
Parties:
Seller (please print):
Buyer (please print):
Purchase Price: The buyer agrees to pay $ to the seller in exchange for the possession and
ownership of the following described motor vehicle:
Vehicle Identification Number
Taxes: Municipal, County, and State taxes in relation to the purchase of the motor vehicle, including sales
taxes, are not included in the purchase price.
Odometer Disclosure Statement
I state that the odometer now reads (No Tenths) and to the best of knowledge that is
reflects the actual mileage of the vehicle unless one of the following statements is checked (only check a
box if applicable):
I certify that to the best of my knowledge the odometer reading reflects the amount of
mileage in excess of its mechanical limits. (The odometer started at zero again)
I certify that the odometer reading is not the actual mileage. WARNING-ODOMETER
DISCREPANCY
Lien Holder Information
I certify that there is no active lienholder on this vehicle.
Seller(s) Signature:
Seller(s) Signature:
Sellers Address:
Date:
Buyer(s): Do not sign below until all sections above have been completed and signed. Signing below
indicates that you are aware of the odometer disclosure statement made by the seller(s).
Buyer(s) Signature:
Buyer(s) Signature:
Buyers Address:
Date:
