Form 82995 - Motor Vehicle Power Of Attorney/odometer Disclosure Instructions Page 3
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5Vehicle Description
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Vehicle Identification Number
Enter the VIN number
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Year
Enter the Year
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Make
Enter the Make
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Body
Enter the Body Type.
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Title No
Enter the title number here
Part A- Seller’s Power of Attorney to Disclose Mileage
Since the title is unavailable, Part A is used as the Federal Odometer Disclosure between the seller and
the purchaser. When the title is received, the information disclosed in Part A will be transferred onto
the title.
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Print Seller’s Name
The seller’s printed name goes in this area.
7
Print Name of Dealership/Business
The dealership’s name goes here.
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Date
Date of appointment
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5 or 6 Digit Odometer
(check the appropriate box)
Remember- most digital odometers are 6 digits.
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Odometer Reading
The odometer reading goes in these boxes. Make sure the reading is accurate
and there are no cross-outs or write-overs.
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Date the Odometer Read
Enter the date of the odometer reading.
Motor Vehicle Form Seminar
01/01/2017
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