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Get Fort Wayne Odometer Disclosure Form

E STATEMENT AND ACKNOWLEDGMENT VEHICLE DESCRIPTION Vehicle Identification Number Year Make Color Body Title Number ODOMETER DISCLOSURE STATEMENT WARNING: Federal and State law requires that you state the mileage in connection with an application for a Certificate of Title. Failure to complete or providing a false statement may result in fines and/or imprisonment. WE STATE THAT THIS 5 or , 6 DIGIT ODOMETER NOWS READS .XX (NO TENTHS) MILES, DATE READ / / , AND WE H.

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