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Get TX VTR-40 2009

ODOMETER DISCLOSURE STATEMENT VTR-40 Rev. 11/09 DHT 142235 Federal and State Law require that you state the mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result in fines and/or imprisonment. This form may not be used in conjunction with title transfer documents which comply with federal and state odometer disclosure requirements such as Texas Certificate of Titles issued on or after April 29 1990. This form may not be used in conjunction with title transfer documents which comply with federal and state odometer disclosure requirements such as Texas Certificate of Titles issued on or after April 29 1990. VEHICLE DESCRIPTION Make Year Body Style Model Vehicle Identification Number I certify to the best of my knowledge that the odometer reading is Seller/Agent Name the actual mileage of the vehicle described above unless one of the following statements is checked Odometer Reading Date of Statement 1. This form may not be used in conjunction with title transfer documents which comply with federal and state odometer disclosure requirements such as Texas Certificate of Titles issued on or after April 29 1990. VEHICLE DESCRIPTION Make Year Body Style Model Vehicle Identification Number I certify to the best of my knowledge that the odometer reading is Seller/Agent Name the actual mileage of the vehicle described above unless one of the following statements is checked Odometer Reading Date of Statement 1. The mileage stated is in excess of its mechanical limits. No Tenths 2. The odometer reading is not the actual mileage. WARNING ODOMETER DISCREPANCY. Signature of Seller/Agent Printed Name Same as Signature If titled in a firm s name print the firm s name on the line above. Street Address City State Zip Code ACKNOWLEDGMENT OF ODOMETER DISCLOSURE BY BUYER/AGENT I am aware of the above odometer certification made by the seller/agent. Signature of Buyer/Agent If purchased by a firm print the firm s name on the line above. WARNING TRANSPORTATION CODE 501. 155 PROVIDES THAT FALSIFYING INFORMATION ON ANY REQUIRED STATEMENT OR APPLICATION IS A THIRD-DEGREE FELONY. VEHICLE DESCRIPTION Make Year Body Style Model Vehicle Identification Number I certify to the best of my knowledge that the odometer reading is Seller/Agent Name the actual mileage of the vehicle described above unless one of the following statements is checked Odometer Reading Date of Statement 1. The mileage stated is in excess of its mechanical limits. No Tenths 2. The odometer reading is not the actual mileage. The mileage stated is in excess of its mechanical limits. No Tenths 2. The odometer reading is not the actual mileage. WARNING ODOMETER DISCREPANCY. Signature of Seller/Agent Printed Name Same as Signature If titled in a firm s name print the firm s name on the line above. WARNING ODOMETER DISCREPANCY. Signature of Seller/Agent Printed Name Same as Signature If titled in a firm s name print the firm s name on the line above. Street Address City State Zip Code ACKNOWLEDGMENT OF ODOMETER DISCLOSURE BY BUYER/AGENT I am aware of the above odometer certification made by the seller/agent. .

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