Use this form as a Bill of Sale For a Mobile Home in the state of Vermont
Vermont Mobile Home Uniform Bill of Sale Form
Text version of this Form
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VERMONT MOBILE HOME UNIFORM BILL OF SALE
Vermont law, 9 V.S.A. §2602, requires that this Mobile Home Uniform Bill of Sale be signed by each Buyer and
Seller, endorsed by the Town Clerk of the Town where the Mobile Home is located at the time of sale, and filed
by Buyer with the Town Clerk of the Town where the Mobile Home will be located within 10 days after the sale.
A financing statement evidencing a security interest in the Mobile Home must be filed with the
Seller(s) or Transferor(s) (“Seller”):
Name(s): ……………………………………………………………………………………………………………………………………………………..
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Address of Second Seller if different from first:
Name(s): ……………………………………………………………………………………………………………………………………………………..
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Mailing Address (if different):
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: …………………………………………………………………………………………………………………………………………..
Buyer(s) or Transferee(s) (“Buyer”):
Name(s): ……………………………………………………………………………………………………………………………………………………..
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Address of Second Buyer if different from first:
Name(s): ……………………………………………………………………………………………………………………………………………………..
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Mailing Address (if different):
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: …………………………………………………………………………………………………………………………………………..
If more than one Buyer, Buyers take title as:
[ ] Joint tenants (co-owners with right of survivorship).
[ ] Tenants by the entirety (joint tenancy of persons who are married).
[ ] Tenants in common (individual interests without right of survivorship).
[ ] ………………………………………………………………………………………………………………………..
Mobile Home Being Sold or Transferred (“Mobile Home”) Specifications:
Make: ………………………………………………………………… Model: ……………………………………………………….. Year: …………
Serial Number: ……………………………………………………………………………………………………………………………………………
Size: ………………………………………………………………….. Color: ………………………………………………………….
Current Location:
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Location of Mobile Home Following Sale (check one):
[ ] Mobile Home will remain at current location.
[ ] Mobile Home will be relocated to the following address (within municipality or different municipality):
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Owner of Real Property (land/lot) on which Mobile Home is Currently Located:
Name: …………………………………………………………………………………………………………………………………………………………
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Vermont Mobile Home Uniform Bill of Sale (rev. DEHCD 8/9/12) Page 1
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Mailing Address (if different):
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: …………………………………………………………………………………………………………………………………………..
Owner of Real Property (land/lot) on which Mobile Home will be Located:
Name: ……………………………………………………………………………………………………………………………………..
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: ……………………………………………………………………………………….. County: …………………………………….
Mailing Address (if different):
Street: …………………………………………………………………………………………………………………………………………………………
Town/State/ZIP: …………………………………………………………………………………………………………………………………………..
Sale is a Retail Installment Transaction
This sale constitutes a “retail installment transaction” as defined in 9 V.S.A. § 2351(4) and is subject to 9 V.S.A.
Chapter 59 (motor vehicle and mobile home retail installment sales financing).
KNOWN DEFICIENCIES IN “AS IS” SALES
In the case of an “as is” sale, the Seller is aware of the following deficiencies and defects of the Mobile Home:
…………………………………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………………………..
KNOWN LIENS
The Seller is aware of the following liens on the Mobile Home:
…………………………………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………………………..
[ ] BY CHECKING THIS BOX SELLER OR TRANSFEROR HEREBY CERTIFIES THAT A
COMPLETED COPY OF THIS FORM WAS PROVIDED TO THE OWNER OF THE REAL PROPERTY
WHERE THE MOBILE HOME IS LOCATED 21 DAYS PRIOR TO TRANSFER.
For good and valuable consideration of ____________________________________dollars ($___________), the receipt
and sufficiency of which is acknowledged, Seller hereby grants, sells, and transfers to the Buyer the Mobile
Home identified in this Bill of Sale, and Seller covenants with Buyer that Seller is the lawful owner of the
Mobile Home, that it is free from all encumbrances, that Seller has good right to sell the Mobile Home, and that
Seller will warrant and defend the same against the lawful claims and demands of all persons.
Seller Signature ………………………………………………………………………….. Date ………………………………………………………
Witness Signature ………………………………………………………………………. Date ………………………………………………………
Buyer Signature …………………………………………………………………………. Date ………………………………………………………
Witness Signature ………………………………………………………………………. Date ………………………………………………………
TOWN CLERK ENDORSEMENT
TO BE COMPLETED BY TOWN CLERK WHERE MOBILE HOME IS CURRENTLY LOCATED PRIOR TO
EXECUTION BY THE BUYER AND SELLER
I hereby acknowledge that:
[ ] all property taxes due and payable on the mobile home, but not the real property on which the mobile home
is located if separately owned, have been paid in full as of the most recent assessment, or if the town collects
taxes in installments pursuant to 32 V.S.A. § 4872, as of the most recent installment; or
[ ] in the case of removal of a mobile home from the municipality, or of a sale, trade, or transfer that will result
in the removal of the mobile home from the municipality, all property taxes assessed with regard to the mobile
home, but not the mobile home site, have been paid.
Town Clerk Signature: ………………………………………………………………… Date: ……………………………………………………..
Town/City of: ……………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………………..
Released: Date________________ Time___________ Received: Date*________________ Time___________
Clerk: ___________________________________________ Clerk ___________________________________________
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WITHIN 14 DAYS OF FILING, CLERK SHALL MAIL A COPY OF THIS FORM TO EACH BUYER, SELLER, AND OWNER OF REAL PROPERTY
Vermont Mobile Home Uniform Bill of Sale (rev. DEHCD 8/9/12) Page 2