Commercial Truck Odometer Disclosure Statement
Vehicle Information
Year
Make
Model
Body Type
Vehicle Identification Number (VIN)
Odometer Reading
Odometer Reading (no tenths)
The mileage stated is in excess of its mechanical limits.
The odometer reading is not the actual mileage.
Seller Information
Name (Printed)
Address
Buyer Information
Name (Printed)
Address
Seller's Signature
Date
Buyer's Signature
Date