Form 1545 - Odometer Statement Of Explanation

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MISSOURI DEPARTMENT OF REVENUE
FORM
1545
MOTOR VEHICLE BUREAU
ODOMETER STATEMENT OF EXPLANATION
(REV. 08-2013)
Section 407.536, RSMo provides in part “. . . If the true mileage is known to the transferor to be different
from the number of miles shown on the odometer or the true mileage is unknown, a statement from the
transferor shall accompany the assignment of title which shall contain all facts known by the transferor
concerning the true mileage of the motor vehicle.” Questions should be referred to (573) 526-3669.
I, ___________________________________________ , state that the odometer on the
TRANSFEROR’S (SELLER) NAME (PRINTED OR TYPED)
vehicle described below now reads ____________________________ miles/kilometers.
ODOMETER READING (EXCLUDING TENTHS)
MAKE
MODEL
BODY TYPE
VEHICLE IDENTIFICATION NUMBER
YEAR
DEALER NUMBER
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __
__ __ __ __ __
CHECK ONE BOX ONLY
1) I hereby certify that this vehicle has no odometer and estimate the mileage to be:
___________ (excluding tenths).
2) I hereby certify that the odometer was altered for repair or replacement while in
my possession, and that the mileage registered on the repaired or replacement
odometer was identical to that before such services.
3) I hereby certify that the replacement odometer was incapable of registering the
same mileage. The replacement odometer reading at the time of replacement
was ___________ miles/kilometers and the original odometer reading before the
replacement was ___________ miles/kilometers.
4) I hereby certify that the repaired or replacement odometer was incapable of
registering the same mileage, that it was reset to zero, and that the mileage on the
original odometer or the odometer before repair was ___________ miles/kilometers.
5) I hereby certify that to the best of my knowledge, the odometer reading as stated
above is not the actual mileage of the vehicle described above, and should not be
relied upon. The true mileage is unknown because: _______________________
________________________________________________________________
________________________________________________________________
TRANSFEREE’S NAME (BUYER)
TRANSFEREE’S SIGNATURE
STREET ADDRESS
CITY
STATE
ZIP CODE
__ __ __ __ __
TRANSFEROR’S SIGNATURE (SELLER)
STREET ADDRESS
CITY
STATE
ZIP CODE
__ __ __ __ __
WEB SITE ADDRESS:
DOR-1545 (08-2013)

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