Odometer Disclosure Statement - Cash 4 Motorcycles

Federal law and section 233a of the Michigan Vehicle Code require that you state the mileage in connection with the transfer of ownership. Failure to complete or providing false statement may result in civil liability, fines and/or imprisonment.

Year

Make

Model

Body Style

Vehicle Identification Number

I certify the odometer reading is:(Required)

(No tenths)

And certify that to the best of my knowledge the odometer mileage is:(Required)

Actual Mileage

Not Actual Mileage - WARNING- ODOMETER DISCREPENCY

Exceeds mechanical limits of odometer (5-digit odometer has rolled over)

Check One
* Note: Mileage cannot be corrected at a later date.

Name of Sellers(Required)

First Last

Email(Required)

Address

Street Address City State ZIP Code

Signature(s) of Seller(s)

Date

Name of Purchaser(s)

Address

Street Address City State ZIP Code

“I am aware of the above odometer certification made by the seller(s).”

Signature(s) of Purchaser(s)

Date

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