Lease Buyout Odometer Statement

Vehicle Information

Year:

Make:

Model:

VIN:

Odometer Disclosure

Odometer Reading:

Date of Reading:

I hereby certify to the best of my knowledge the odometer reading reflects the actual mileage of the vehicle.

Seller (Lessor)

Name:

Address:

Signature:

Date:

Buyer (Lessee)

Name:

Address:

Signature:

Date: