Nebraska Motor Vehicle Bill of Sale Form

Use this form as a Bill of Sale To sell a Motor Vehicle in the state of Nebraska

Nebraska Motor Vehicle Bill of Sale Form

Text version of this Form

———————– Page 1———————–

State of Nebraska

Department of Motor Vehicles

BILL OF SALE*

DATE OF SALE

(MO/DAY/YEAR)

I, in consideration of the payment of the sum of $

Transferor (Seller) PLEASE PRINT

acknowledge receipt of payment from and do hereby sell and

Transferee (Buyer) PLEASE PRINT

transfer ownership of the motor vehicle described below:

Vehicle Information

Year Make Model VIN

Transferor Information Transferee Information

Full Name Full Name

Address Address

City State Zip City State Zip

Phone Number Phone Number

Transferor’s (Seller) Signature Transferee’s (Buyer) Signature

Seller warrants that he/she is the lawful owner of the motor vehicle described above and that it is free and clear of all

liens, security agreements, encumbrances, claims, demands and charges.

Subscribed and sworn before me the day Subscribed and sworn before me the day

of of

Signature of Notary Public or Designated County Official Signature of Notary Public or Designated County Official

My commission expires on My commission expires on

SEAL SEAL

*Note: Individuals transacting a motor vehicle transfer of ownership must complete a Bill of Sale at the time of sale.

They are NOT, however, required to use this Bill of Sale form.

This Bill of Sale form is made available by the Nebraska Department of Motor Vehicles as a courtesy.

Revised 2/2011

301 Centennial Mall South ● PO Box 94789 ● Lincoln, NE 68509-4789 ● (402) 471-3918 ● TDD (402) 471-4154 (Hearing Impaired Only)