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Sample. ODOMETER DISCLOSURE STATEMENT. Federal and State law requires that you state the mileage upon transfer of ownership.You need to complete, print, sign and submit the correct form listed here to the appropriate DMV office in your state. Washington: The Odometer Disclosure Statement form is printed on tamper-proof paper, and not available online. Learn more to get one faxed or e-mailed to you. Complete tasks online. Odometer disclosure statement form (Form 10-313) Arkansas PandaDoc. Or State of Arkansas Vehicle Bill of Sale Odometer Disclosure Statement Form. Payment for your registration fees. A signed lien contract.