MV-905: New York Self-Storage Owner/Operator Affirmation and Bill of Sale

Under SELF-STORAGE COMPANY (Business Name and Address), enter the Name, Number and Street Address (including Apt. No.), City, State and Zip Code.

Under PRIOR OWNER, enter the Name as Last Name, First, M.I., the Number and Street Address (including Apt. No.), City, State and Zip Code.

Under DESCRIPTION OF VEHICLE OR BOAT, enter the Year, Make, Model, Plate Number, State and Vehicle or Hull Identification Number (attach photo or tracing).

Under LIENHOLDERS (attach additional page, if necessary), enter for 1. and 2. the Name, Number and Street Address (including Apt. No.), City, State and Zip Code.

By signing you say that you waited 10 days from the date of service of the Notice of Lien to publish the notice of impending sale, and waited 15 days from the date of the first publication of the notice to conduct the sale. No action was brought under Section 182 of the Lien Law, or an action was brought and the determination was in your favor. The Notice of Lien was sent to owner(s) and lienholder(s). Proof of mailing is attached.

Under PUBLICATION AND SERVICE OF NOTICE INFORMATION, enter the Date of service of notice to owner, the Date of service of notice to lienholder(s), the 1st Publication Date, the 2nd Publication Date, the Sale Date, and the Name and address of newspaper.

Under BUYER, Print Last Name, First, M.I., the Number and Street Address (including Apt. No.), City, State and Zip Code, and enter the Address Where Auction Was Held and the Price Paid.

Federal and state laws require that you state the mileage and condition of the vehicle described in DESCRIPTION OF VEHICLE OR BOAT when transferring ownership. Failure to provide mileage and condition information, or providing false information, may result in fines and/or imprisonment.

The ODOMETER DISCLOSURE STATEMENT does not apply to boats. After I, enter the Self-Storage Owner/Operator (Print Name in Full), state the miles the odometer now reads (no tenths), and check the appropriate box: the odometer on the vehicle described in DESCRIPTION OF VEHICLE OR BOAT has 5 digits, 6 digits or 7 digits, not including tenths.

Check box 1 when, to the best of your knowledge, this odometer reading reflects the ACTUAL MILEAGE as seen on the odometer of the vehicle.

Check box 2 when, to the best of your knowledge, this odometer reading "EXCEEDS MECHANICAL LIMITS" (Odometer started over at zero).

Check box 3 when, to the best of your knowledge, this odometer reading is "NOT THE ACTUAL MILEAGE. WARNING: ODOMETER DISCREPANCY".

In the Damage Disclosure Statement, check one box: "has" or "has not" for the vehicle being wrecked, destroyed or damaged to such an extent that the total estimate, or actual cost, of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident, and for legal operation on the road or highways, is more than 75% of the retail value of the vehicle at the time of loss. Checking the "has" box means the vehicle must have an anti-theft examination before being registered, and that the title issued will have the statement "Rebuilt Salvage: NY" on it.

By signing you state that the information in the "Statements" is true to the best of your knowledge.

Making a false statement, or failure to accurately disclose the salvage status of a vehicle, may subject you to substantial civil fines, in addition to any penalties authorized by the Penal Law.