Text version of this Form
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Title and Registration Bureau
1003 Buckskin Drive, Deer Lodge, MT 59722-2375 Phone (406) 846-6000 Fax (406) 846-6039 [email protected]
*** This form must be completed in its entirety ***
As recorded on this form, I received the sum of dollars
($________________) and other valuable consideration to sell, transfer and deliver to
Purchaser DL/FEIN/Tribal ID/Corp ID
my right, title and interest to the following described vehicle/vessel:
Year Make Model Style
Vehicle/Hull identification no. License plate no.
Salvage Vehicle (must be 5 years or older): Yes No Sold for parts only: Yes No
The (check one) five or six digit odometer now reads (no tenths) ________________ miles, date read
__________________ and, to the best of my knowledge, it reflects the actual mileage unless one of the following
statements is checked:
DO NOT CHECK The odometer reading reflects the amount of mileage in excess of its mechanical limits.
UNLESS APPLICABLE The odometer reading is not the actual mileage. Warning – odometer discrepancy.
I, (purchaser) am aware of the odometer certification made by the seller above.
Purchaser’s signature Date
This is my legal signature
Purchaser’s printed name
Electronic title acknowledgement if electronic title transfer is required in accordance with MCA 61-3-220(1)(a) & (2),
I certify that:
• I am not in possession of the title
• I am the owner of this vehicle and I authorize the transfer to the above-named purchaser
• I have not previously transferred to another person for sale.
I further certify that:
• I have the right to sell the vehicle/vessel described above and will warrant and defend the title against the claims and
demands of all persons except the secured party noted on the Montana title application.
• Under penalty of law (MCA 45-7-203 Unsworn Falsification to Authorities) the statements made on this form are true
and correct to the best of my knowledge, information and belief, and if signing for a commercial entity, I have full authority to
Seller’s signature Date
This is my legal signature (All owners must sign).
Seller’s printed name
If signing for a commercial entity, give full entity name
Notary: State of Subscribed and affirmed to before on (date)
County of by
Name of person appearing before me
Title or Rank
(seal) Notary for the State of
My Commission Expires
Montana county and state authorities reserve the right to reject any form that has been altered
MV24 (03/09) This form is available in alternate formats for people with disabilities