ODOMETER DISCLOSURE STATEMENT
I, ____________________________, a Notary Public in the state of ______________________,
in the county of _________________, have personally verified the mileage of _______________
(miles) on this__________ (year) ________________ (make) _________________ (model)
_____________________________ (VIN) belonging to ____________________________ on
this _______ day of _____________, 20____. _______________________________, owner,
personally appeared and proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to within this instrument.
__________________________________ |
___________________ |
Registered Owner |
Date |
S |
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E |
________________________________ |
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Notary Public |
A |
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My commission expires on ____________________ |
L |
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