The signature for a company or business MUST include the printed name of the company/business and an authorized representative's countersignature on the signature line (e.g., ABC CO., by JOHN SMITH - or - JOHN SMITH for ABC co.). NOTE: Co-owners joined by " AND" (shown by "/" on DMV records) require the signature of EACH owner co-owners joined by " OR" require the signature of at least ONE owner. To be completed by the seller to provide name and address, release ownership, and/or disclose mileage to the buyer. To be completed by the buyer to provide name and address, accept the responsibility of ownership, and/or acknowledge mileage reported. ![]() SECTION 4 - BUYER/SELLER INFORMATION (Individual, Company, Dealership, Lessor/Lessee or Trust) Dealers and Auto Auctions are required to retain a photocopy of the odometer disclosure for 5 years.įederal law requires the hand printed name, date and signature of the buyer and seller when disclosing and acknowledging the odometerreading. Photocopies may be retained for personal record. Any alteration (write-over, cross-out, erasure, deletion, etc.), made to the reported mileage will VOID the odometer disclosure section of this document and a new odometer statement (including the signature of both parties) is mandatory. To be completed by the seller disclosing the mileage at the time of sale. SECTION 3 - ODOMETER DISCLOSURE STATEMENT To be completed by the seller of the vehicle/vessel, identifying the buyer and/or gift recipient, the purchase price or gift value, and date of sale and/or gift. SECTION 1 - VEHICLE / VESSEL IDENTIFICATION Read the Car Buyer's Bill of Rights (FFVR 35) and What you Need to Know Before Buying a Vehicle (FFVR 26) brochures and other brochures available at. PHOTOCOPIES OF THE FORM MAY BE RETAINED FOR YOUR RECORDS. IT MUST ACCOMPANY THE TITLE OR APPLICATION FOR A DUPLICATE TITLE. THIS FORM IS NOT THE OWNERSHIP CERTIFICATE. SIGNATURE REQUIRED BY PERSON APPOINTING POWER OF ATIORNEY I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.Īs my attorney in fact, to complete all necessary documents, as needed, to transfer ownership as required by law. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ![]() I acknowledge the odometer reading and the facts of the transfer. ![]() SECTION 4 - BUYER AND SELLER (MUST hand print his or her name, date and sign this section.) □Odometer reading is NOT the actual mileage □ Mileage EXCEEDS the odometer mechanical limits Explain odometer discrepancy: The odometer now reads □□□□□□10, ths (no tenths) miles, and to the best of my knowledge reflects the ACTUAL mileage unless one of the following statements is checked. Failure to complete or providing a false statement may result in fines and/or imprisonment. SECTION 3 - ODOMETER DISCLOSURE STATEMENT (Void if Mileage is Altered or Erased)įederal and State Law requires that you state the mileage upon transfer of ownership.
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