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Free Vermont Motor Vehicle Bill of Sale Form - PDF Form Download

Vermont Motor Vehicle Bill of Sale Form Overall rating: ☆☆☆☆☆ 0 based on 0 reviews
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This Form is used as a Bill of Sale To sell a Motor Vehicle In the State of Vermont

Vermont Motor Vehicle Bill of Sale Form


Text version of this Form

———————– Page 1———————–

Bill of Sale and Odometer Disclosure Statement

DEPARTMENT OF MOTOR VEHICLES 120 State Street

Agency of Transportation Montpelier, Vermont 05603-0001

802.828.2000

dmv.vermont.gov

If the vehicle being sold is 9 years old or newer and you are not submitting a separate Odometer Disclosure

Statement, please complete the Odometer Disclosure Statement on the back of this form.

I / We (Seller(s) 

(If a company, give company name)

hereby sell, assign or transfer ownership of the vehicle/vessel described below:

 Make  Model  Year  Body/Hull Type  Vessel Length  Color

Boats ft. Boats in.

 Vehicle/Vessel Identification Number  Odometer Reading (Vehicles only)

 Miles  Kilometers

 Hours

To:

New Owner (Purchaser or Transferee) New Co-Owner

On: – – For: $

M M D D Y Y Y Y Purchase Price

IF VEHICLE IS SALVAGE, SALVAGE AND REBUILT OR TOTALED THIS SECTION MUST BE COMPLETED:

I/We also certify that the motor vehicle described above is:

 Salvage  Salvaged and Rebuilt  Declared a total loss by insurer

Any person who sells trades or offers for sale or trade any interest in a salvaged, salvaged and rebuilt or totaled vehicle shall disclose the fact that the vehicle has been

salvaged, salvaged and rebuilt or totaled to a prospective purchaser both orally and in writing before a sale, trade or transfer is made. Written disclosure that the vehicle has

been salvaged, salvaged and rebuilt or totaled, in addition to being disclosed on the certificate of title as required by this subchapter, shall also be conspicuously disclosed on

any bill of sale, transfer, purchase or other agreement.

Failure of the seller to provide the notices required by this section shall result in the seller being required, at the option of the buyer, to refund to the buyer the purchase price,

including taxes, license fees and similar governmental charges.

This information has been conveyed to the purchaser, both orally and in writing in accordance with 23 V.S.A. Sections 2093 (b) (c), Salvaged, totaled and rebuilt vehicles.

If this section completed new owner sign:

Purchaser’s signature: Date:

The vehicle/vessel is free of all liens and encumbrances. Statements and warrants made herein are certified under penalty of

23 V.S.A. Sections 202, 203, 2082 & 3829 (4). If vehicle is jointly owned, both owners must sign.

 Seller’s Signature – if company, Authorized Representative (include title)  Date

Owner:

Co-Owner:

 Seller’s Address  Seller’s Phone Number

 Buyer’s Signature – if company, Authorized Representative (include title)  Date

Owner:

Co-Owner:

 Buyer’s Address  Buyer’s Phone Number

TA-VT-05 50M 07/2012 REB Vermont Telecommunications Relay Service Dial 711

———————– Page 2———————–

Odometer Disclosure Statement

Odometer Disclosure Statement must be signed by both the buyer and seller. Failure to complete as requested will result

in return for completion.

An Odometer Disclosure Statement must be submitted for vehicles that are nine (9) years old and newer, self-propelled and

with a registered weight of 16,000 lbs or less.

Federal and State laws require that the Seller/Lessee disclose the mileage to the Buyer/Lessor in connection with the

transfer of ownership. An inaccurate statement, or failure to complete the statement, may result in fines and/or imprisonment,

pursuant to Section 409(a) of the Federal Motor Vehicle Information and Cost Savings Act of Public Law 92-513, and

pursuant of Vermont’s Consumer Fraud Law.

Section 1 – Vehicle Information

Year Make Model

Vehicle Identification Number (VIN) Body type

Section 2 – Odometer Disclosure

Federal and State law require that you furnish to the buyer a written odometer disclosure statement upon transfer of

ownership. Failure to complete or providing a false statement may result in fines and/or imprisonment.

I certify that the odometer reading: (check one)

Reflects the actual mileage.

Reflects the mileage in excess of the odometer’s mechanical limits. (A)

Enter odometer reading (no tenths)

Is not the actual mileage. Warning – Odometer Discrepancy (B)

Section 3 – Seller/Transferor Information

Seller’s name (print last, first, middle initial, or business name)

Seller’s address City State Zip code

Seller’s signature Date of statement

X

Section 4 – Buyer Information

Buyer’s name (print last, first, middle initial, or business name)

Buyer’s address City State Zip code

Buyer’s signature Date of statement

X

Statements and warrants made herein are certified under penalty of 23 V.S.A. Sections 202,

203, 2082 & 3829 (4). If vehicle is jointly owned, only one (1) seller signature is required.

TA-VT-05 50M 07/2012 REB Vermont Telecommunications Relay Service Dial 711

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