Notice Of Sale And/or Bill Of Sale For A Motor Vehicle, Mobile Home, Off-Highway Vehicle Or Vessel

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STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTOR VEHICLES, Neil Kirkman Building - Tallahassee, FL 32399
Notice of Sale and/or Bill of Sale for a Motor Vehicle, Mobile Home,
Off-Highway Vehicle or Vessel
Notice of Sale (Seller ONLY must complete sections 1 & 3). Purchaser does not need to sign.
Bill of Sale (Seller and purchaser must complete sections 1, 2, when applicable & 3)
1.
Motor Vehicle, Mobile Home, Off- Highway or Vessel Description
Year
Make/Manufacturer
Body Type
Model
Color
Certificate of Title Number
Identification Number
I do hereby sell or have sold and delivered the above described motor vehicle, mobile home,
off-highway vehicle or vessel to:
Print Name(s) of Purchaser(s)
Address
City
State
Zip Code
Date of Sale
Selling price
$
2.
Odometer Disclosure Statement (Required For a Motor Vehicle)
Federal and State law requires that you state the mileage in connection with the transfer of ownership. Failure
to complete or providing a false statement may result in fines and/or imprisonment.
WE STATE THAT THIS MOTOR VEHICLE’S
5 DIGIT OR
6 DIGIT ODOMETER NOW READS
,
(NO TENTHS) MILES, DATE READ ________/________/________, AND WE HEREBY CERTIFY
.XX
THAT TO THE BEST OF OUR KNOWLEDGE THE ODOMETER READING:
1. REFLECTS THE ACTUAL MILEAGE.
2. IS IN EXCESS OF ITS MECHANICAL LIMITS.
3. IS NOT THE ACTUAL MILEAGE.
3.
Certification
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS
STATED IN IT ARE TRUE.
Seller's Signature
Seller's Printed Name
Date
Seller's Address
City
State
Zip Code
Co-Seller's Signature (if applicable)
Co-Seller's Printed Name (if applicable)
Date
Co-Seller's Address (if applicable)
City
State
Zip Code
Purchaser's Signature
Purchaser's Printed Name
Date
Co-Purchaser's Signature (if applicable)
Co-Purchaser's Printed name (if applicable)
Date
OWNERSHIP STATUS FOR THE ABOVE DESCRIBED MOTOR VEHICLE, MOBILE HOME, OFF-HIGHWAY VEHICLE OR VESSEL
WILL NOT CHANGE UNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
HSMV 82050 (Rev. 01/06) S

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