New York Motor Vehicle Bill of Sale Form

The New York Motor Vehicle Bill of Sale Form is a document used in the state of New York to record a sale of a vehicle from a garage-man (e.g. a mechanic or attendant) to an individual. It is a sworn statement from the garage-man concerning the sale of the vehicle to obtain compensation for unpaid repairs, towing and/or storage charges.

Everything on the New York Motor Vehicle Bill of Sale Form must be completed where applicable and the form must contain the original signatures of the garage-man and the purchaser. The original affirmation and bill of sale (the New York Motor Vehicle Bill of Sale Form) must be given to the purchaser.

Section 1:-

  1. The garageman enters their details: Their full name, address (including Zip Code) and facility number
  2. The prior owners full name and address (including Zip Code) are entered
  3. Where there are any lien holders their full name(s) and address (es) are entered. A lien holder is someone who has either leased a vehicle to the owner or given them money on loan to buy it. A lien holder is usually a bank or another form of financial firm. If there are more than two lien holders then the further details should be entered on an additional sheet

Section 2:-

  1. Enter the date on which the prior owner was notified of the sale
  2. Enter the date on which the lienholder was notified of the sale
  3. Enter the first and second date on which the details of the sale were publish in the newspaper (the name and address of the newspaper is entered under these dates)
  4. On the right hand side of the two dates of publication, enter the actual sale date

Section 3 – Odometer Disclosure Statement:-

This is only applicable where a motor vehicle is being sold, and is a statement made by the garageman. The garageman enters their full name and the mileage shown on the odometer. The garageman then ticks either the ‘5 digits’, ‘6 digits’ or ‘7 digits’ box depending on the number of digits on the odometer. The garageman then ticks the appropriate declaration out of those numbered (1) to (3)

Section 4 – Damage Disclosure Statement:-

The appropriate declaration should be ticked (either that the vehicle has or has not been wrecked, destroyed or damaged to the extent that it is written off)

The document must then be signed by both the buyer and the garageman

New York Motor Vehicle Bill of Sale Form

Text version of this Form

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MV-901B (9/10) New York State Department of Motor Vehicles

GARAGEMAN’S AFFIRMATION AND BILL OF SALE

This form is also available to download from the DMV website: www.dmv.ny.gov

GARAGEMAN (Business Name and Address) PRIOR OWNER

Name Facility No. Last Name,

First, M.I.

Number and Number and Apt. No.

Street Address Street Address

City State Zip Code City State Zip Code

DESCRIPTION OF VEHICLE OR BOAT

Year Make Model Plate Number State Vehicle or Hull Identification Number (attach photo or tracing)

LIENHOLDERS (attach additional sheet, if necessary)

1. Name 2. Name

Number and Apt. No. Number and Apt. No.

Street Address Street Address

City State Zip Code City State Zip Code

I (We) waited 10 days from the date of service of the Notice of Lien to publish the notice of impending sale, and waited 15 days from the date of the first publication

of the notice to conduct the sale. No action was brought under Section 201-a of the Lien Law, or an action was brought and the determination was in my (our) favor.

Notice of Lien was sent to owner(s) and lienholder(s). Proof of mailing is attached. The sale was published in accordance with Section 202 of the Lien Law.

PUBLICATION AND SERVICE OF NOTICE INFORMATION

Date of service of notice to owner: / / Date of service of notice to lienholder(s): / /

1st Publication Date: / / 2nd Publication Date: / / Sale Date: / /

Name and address of newspaper:

BUYER

Print Last Name, Address Where Auction Was Held

First, M.I.

Number and Apt. No.

Street Address

PRICE PAID:

City State Zip Code ($0 [zero dollars]

is not acceptable)

ODOMETER DISCLOSURE STATEMENT (does not apply to boats)

Federal and state laws require that you state the mileage and condition of the vehicle described above when transferring ownership of it to

someone else. If you do not give the mileage and condition information to the new owner(s), or if you give false mileage information, you may

be subject to fines and/or imprisonment.

I, _____________________________________________________________ state that the odometer now reads ___________________miles

Garageman, Print Name in Full (no tenths)

The odometer on the vehicle described above has (check the appropriate box): 5 digits 6 digits 7 digits, not including tenths.

1.I certify that, to the best of my knowledge, this odometer reading reflects the ACTUAL MILEAGE as seen on the odometer of the

vehicle described above.

2. I certify that, to the best of my knowledge, this odometer reading “EXCEEDS MECHANICAL LIMITS”. (Odometer started over at zero).

3.I certify that, to the best of my knowledge, this odometer reading is

“NOT THE ACTUAL MILEAGE WARNING: ODOMETER DISCREPANCY”.

DAMAGE DISCLOSURE STATEMENT – CHECK ONE BOX

I certify that, to the best of my knowledge, this vehicle has been or has not been wrecked, destroyed or damaged to such an extent that the

total estimate, or actual cost, of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident, and for legal

operation on the road or highways, is more than 75% of the retail value of the vehicle at the time of loss. (Checking the “has” box means the

vehicle must have an anti-theft examination before being registered and that the title issued will have the statement “Rebuilt Salvage: NY” on it.)

The information in these statements is true to the best of my knowledge.

_________________________________________________ _____________________________________________

(BUYER’S SIGNATURE) (GARAGEMAN’S SIGNATURE)

IMPORTANT: False statements are punishable under Section 392 of the Vehicle and Traffic Law and Section 210.45 of the Penal Law.

CERTIFICATE OF TITLE REQUIRED FOR REGISTRATION

The vehicle described above cannot be registered until Title Services has reviewed the buyer’s application for title and supporting

documentation, and issued a Certificate of Title for the vehicle.