Fill and Sign the Pa Odometer Statement Form

BILL OF SALE OF AUTOMOBILE To be completed upon sale of motor vehicle. State of Pennsylvania County of _______________ $_______________ FOR AND IN CONSIDERATION OF ___________________ Dollars ($___________) cash in hand, paid me this day in full by____________________________, (Buye r(s), ____________________________, “Seller(s)”do hereby bargain a nd sell to Buyer(s) the following personal property: One (1) Motor Vehicle Make _____________________ Model ________________ Body Type ________________ Vehicle Identification Number (VIN) ________________ Year: _____ The said property I guarantee is my own and free of all claims and offsets of any and all kinds. To have and to hold the same unto Buyer(s) and Buyer(s) executo rs, administrators and assigns, forever. Seller(s) hereby covenant to and with Buyer(s)that Seller(s) is the true and lawful owner(s) of the above-described motor vehicle, that the same is free from all e ncumbrances whatsoever except __________________________ (lienholder), that Seller(s) 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 except the above lien, if any. Seller(s) ________________________ Signature Print Name: _______________________ ________________________ Signature Print Name: _______________________ SWORN TO AND SUBSCRIBED BEFORE ME, this the ____ day of _____________ ___, 20____. ____________________________ NOTARY PUBLIC My Commission Expires: ________________________ U.S. Legal Forms, Inc. http://www.uslegalforms.com Form US-00431 ODOMETER DISCLOSURE STATEMENTTo 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, _______________________________ , state that the odometer now reads _______________ 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 Type or Print): Street Address: City: State: Zip: Transferee's (Buyer's) Information Transferee's Name (Please Type or Print): Street Address: City: State: Zip: Signature of Transferee (Buyer): ____________________________ DATE OF STATEMENT: STATE OF PENNSYLVANIA COUNTY OF _______________ SWORN TO AND SUBSCRIBED BEFORE ME, this the _____ day of ____________ ___, 20_____. ____________________________ NOTARY PUBLIC My Commission Expires: ________________________ ORIGINAL MUST BE PROVIDED WITH APPLICATION FOR A CERTIFICATE OF TITLE