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Describe the situation with the odometer, name the miles that are currently on the odometer; Fill the seller's section with the signature, printed name, address, and certification date; Leave the buyer's section empty for the buyer to fill.
An odometer disclosure statement is a legal document that states the accurate mileage on a vehicle's odometer at the time of transfer from the seller to the buyer. If the seller knows that the car's mileage is incorrect, the document must contain that information.
Seller's Signature Seller's Name (Print Name in Full) Mailing Address (Include Street Number and Name, Rural Delivery, Box, Apt. No.) Enter odometer reading exactly as it appears on the vehicle's odometer (excluding tenths) and check applicable boxes.
Odometer disclosure is mandatory on vehicles less than 10 model years old.
This written disclosure must be signed by the transferor, including the printed name, and shall contain the following information: (1) The odometer reading at the time of the transfer (not to include tenths of miles); (2) The date of the transfer; (3) The transferor's name and current address; (3a) The transferee's ...