RV-F1317001: TN Odometer Disclosure Statement

INSTRUCTIONS: In Section A, the seller (transferor) prints their name on the line and checks one box that best applies. In Section B, the seller (transferor) and/or buyer (transferee) complete the required information, including the date of transaction.

Check one: 1. Actual Mileage of the vehicle, no discrepancies, with the odometer reading entered (NO TENTHS).

Box 2, In Excess of Mechanical Limits: check only if digits on odometer are impossible to determine.

Box 3, Not Actual Mileage: the odometer reading is not the actual mileage. WARNING - Odometer Discrepancy form must be completed, or titling transaction will be delayed.

Enter the VIN, Year, Make and Model.

Enter the Seller Address, City, State and Zip.

Under SIGN, the seller enters the Seller Signature and the Date.

The buyer enters the Buyer Address, City, State and Zip, the Buyer Name (Print), the Buyer Signature and the Date.

Federal and state law require both seller (transferor) and buyer (transferee) to accurately state the mileage of any used motor vehicle, with a manufacture year of 2011 or newer, in connection with the transfer of ownership whether sale, trade-in or exchange. Failure to complete or providing a false statement may result in fines and/or imprisonment.

EXEMPTIONS, as defined by NHTSA (National Highway Traffic Safety Administration), "a transfer of any of the following motor vehicles need not disclose the vehicle's odometer mileage under the following circumstances: a) Gross Vehicle Weight Rating of more than 16,000 pounds

b) Vehicle not self-propelled c) Vehicle is model year 2010 or older

d) Vehicle sold directly by the manufacturer to any agency of the United States in conformity with contractual specifications e) New vehicle prior to first transfer for purposes other than resale