Leased Vehicle Odometer Disclosure Statement printable pdf download

Leased Vehicle Odometer Disclosure Statement

LEASED VEHICLE ODOMETER DISCLOSURE STATEMENT

ATTACHMENT –B–

TO: MOTOLEASE, LLC

, state that the odometer now reads

miles

(Print name of person making disclosure)

(no tenths)

and I hereby certify to the best of my knowledge that the odometer reading of the vehicle described below:

(please check one of following statements)

____ (1) reflects the actual mileage

____ (2) reflects the amount of mileage in excess of its mechanical limits

____ (3) is NOT the actual mileage. WARNING - ODOMETER DISCREPANCY

Year ________________ Make ________________________________ Model _____________________

Vehicle Identification Number ______________________________________________________________

LESSEE / CUSTOMER INFORMATION:

Lessee Name (printed) ________________________________________ Date _______________________

Lessee Signature _________________________________________________________________________

Lessee Phone ____________________________________________________________________________

Lessee Address __________________________________________________________________________

(Street)

__________________________________________________________________________

(City)

(State)

(Zip)

LESSOR INFORMATION:

Lessor Signature _____________________________________________ Lessee _____________________

Date of Statement ______________________________ Date Received by Lessor ____________________

MOTOLEASE, LLC - 10866 Wilshire Blvd. Ste.565, Los Angeles CA 90024

Tel 877.234.6681 |Fax 866.868.8003 |Email support@motolease.net |

Leased Vehicle Odometer Disclosure Statement