Motorcycle Odometer Statement

Seller Name:

Address:

City, State, ZIP:

Buyer Name:

Address:

City, State, ZIP:

Motorcycle Make:

Model:

Year:

VIN (Vehicle Identification Number):

Odometer Reading (No Tenths):

I certify that, to the best of my knowledge, the odometer reading reflects the actual mileage of the vehicle described above unless one of the following statements is checked:

The mileage stated is in excess of its mechanical limits.

The odometer reading is not the actual mileage. WARNING—ODOMETER DISCREPANCY.

Date of Statement:

Seller Signature:

Buyer Signature: