Fill and Sign the Ma Selling Form

BILL OF SALE OF AUTOMOBILE MASSACHUSETTS $______________ County of __________________ (Purchase Price) FOR AND IN CONSIDERATION OF the execution of a Promissory Note for $________________, and down payment of $ _________________, by __________________________________ (Name of Buyer) to ______________________________________ (Name of Seller) , Seller does hereby bargain and sell to Buyer the following personal property: One (1) Motor Vehicle more particularly described as follows:  Make ____________________________________________  Model ____________________________________________  Body Type ____________________________________________  Vehicle Identification Number (VIN) _________________________________  Year: _______________ Except as qualified below, I guarantee that the said property is my own and free of all claims and offsets of any and all kinds. To have and to hold the same unto Buyer and Buyer’s executors, administrators and assigns, forever. Except as qualified below, Seller hereby covenants to and with Buyer that Seller is the true and lawful owner of the above-described motor vehicle, that the same is free from all encumbrances whatsoever except the vendor’s lien retained by Seller, that Seller has good right to sell the same as aforesaid, and that Seller will warrant and defend the same against all lawful claims and demands whatsoever. Seller is selling all of his _____% interest in the motor vehicle to Buyer who owns a _____ % interest in said motor vehicle. Seller is selling said motor vehicle in its as is and present condition and makes no warranty as to the condition of the motor vehicle and waives any implied warranty of fitness for a particular purpose or merchantability. By acceptance of this Bill of Sale, Buyer accepts motor vehicle in its as is and present condition and agrees that Seller has made no warranty as to the condition of the motor vehicle nor any implied warranty of fitness for a particular purpose or merchantability. _________________________________________ Signature of Seller __________________________________________ Printed Name of Seller Sworn to and subscribed before me this ____________________________________ (date) . ________________________________________ Notary Public My Commission Expires: __________________________ ODOMETER DISCLOSURE STATEMENT To be completed by Transferor (Seller) Federal law (and State law, if applicable) requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false statement may result in fines and/or imprisonment. I, ___________________________________________ (Name of Seller) , state that the odometer now reads _______________ (Number) miles and to the best of my knowledge that it reflects the actual mileage of the vehicle described below, unless one of the following statements is checked. [ ] I hereby certify that to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits. [ ] I hereby certify that the odometer reading is NOT the actual mileage. WARNING - ODOMETER DISCREPANCY.  Make ____________________________________________  Model ____________________________________________  Body Type ____________________________________________  Vehicle Identification Number (VIN) _________________________________ Year: ____________________________________________ ___________________________________________ Signature of Transferor (Seller) Transferor’s (Seller’s Information) Transferor’s Name (Please Print or Type) ________________________________________ Street Address______________________________________________ City__________________________ State________________________ Zip_____________ Transferee’s (Buyer’s Information) Transferee’s Name (Please Print or Type) ______________________________________________ Street Address_______________________________________________ City__________________________ State________________________ Zip______________ ___________________________________________ Signature of Transferee (Buyer) DATE OF STATEMENT: __________________ State of Massachusetts County of ______________________ Sworn to and subscribed before me this _________________________________________ (date) . ___________________________________________ Notary Public My Commission Expires: _________________________ ORIGINAL MUST BE PROVIDED WITH APPLICATION FOR A CERTIFICATE OF TITLE