Odometer Disclosure Statement
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Odometer Disclosure Statement template is included in the software package. Download Blitz Document Automation software |
Odometer Disclosure Statement
I, [NAME], STATE AND DECLARE
that the following vehicle's (the 'Motor Vehicle')
odometer reads as follows:
| Make | Model | Year |
| Toyota | Corolla | 2003 |
| Current Odometer Reading | Vehicle Identification Number (VIN) | Body Type |
| 12,000 miles | XTA210530T1635057 | 5 dr hatchback |
I CERTIFY that to the best of my knowledge the odometer reading as stated above reflects the actual mileage of the Motor Vehicle.
I CERTIFY that the odometer of the Motor Vehicle was altered for repair or replacement purposes while in my possession, and that the mileage registered on the repaired or replacement odometer is identical to that before the service.
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SIGNED, SEALED AND DELIVERED
this 11th day of July, 2009 in the presence of: | [NAME] | |
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WITHESS: |
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Receipt of original copy is hereby acknowledged by [NAME] |
[NAME] Address: [CITY], [STATE], [ZIP CODE] | |