Idaho Transportation Department
Supply # 019677178
Vehicle or Hull Identification Number (1
st
)
Vehicle Identification Number (2
nd
) See Note*
*Note: Second VIN should be provided for most motor homes and must be entered for double-wide mobile and manufactured homes.
Brands: Rebuilt Salvage Previous Brand Reconstruct Repaired Other
Odometer Reading (No Tenths)
Exceeds Mechanical Limits
Seller’s Full Legal Printed Name
Buyer’s Full Legal Printed Name
Idaho Driver’s License Number or SSN / EIN if Business
Mailing Address (If different than physical address)
Mailing Address (If different than physical address)
$
New Lienholder Name or “None”
Seller
I hereby sell the vehicle described above for the selling price indicated. I certify that the odometer reading given is
accurate to the best of my knowledge. I also certify that I have disclosed to the buyer all known brands associated
with this vehicle. I understand that I must file a release of liability statement within five days of delivering the vehicle to
the buyer. I also understand that listing a false selling price, name, or address on this form is a felony under Section
49-518(5), Idaho Code.
Buyer
I am aware of the odometer certification made by the seller, and understand the seller must disclose any brands that
have been placed on this vehicle. I also understand that I must apply for title within 30 days to avoid a penalty
whether the vehicle is registered or not.