Odometer Statement Pdf Details

As a Tennessee motorist, it's important to be aware of the odometer disclosure statement TN form. This document is required when you sell or transfer ownership of a vehicle, and is used to certify the accuracy of the odometer reading. By understanding what this form is and how to complete it, you can avoid potential complications down the road.

You'll find information about the type of form you want to submit in the table. It will show you the length of time you'll need to finish odometer disclosure statement tn, exactly what fields you need to fill in and several other specific details.

QuestionAnswer
Form NameOdometer Disclosure Statement Tn
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesodometer statement pdf, odometer disclosure statement tennessee, tennessee department of revenue odometer disclosure statement, tn odometer disclosure form

Form Preview Example

TENNESSEE DEPARTMENT OF REVENUE

ODOMETER DISCLOSURE STATEMENT

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.

I,

SELLER OR TRANSFEROR’S NAME (PLEASE PRINT)

certify to the best of my knowledge that the odometer reading on the vehicle described below is the actual mileage of the vehicle unless one of the following statements is checked:

ODOMETER READING (NO TENTHS)

1 I hereby certify that the mileage stated is in excess of the mechanical limits of the odometer.

2 The odometer reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY.

MAKE

MODEL

BODY TYPE

VEHICLE IDENTIFICATION NUMBER

YEAR

SELLER OR TRANSFEROR’S ADDRESS CITYSTATEZIP CODE

X

 

SELLER OR TRANSFEROR’S SIGNATURE

 

DATE OF THIS STATEMENT

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S NAME (PLEASE PRINT)

 

 

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S ADDRESS

CITY

STATE

ZIP CODE

X

 

 

 

 

 

BUYER OR TRANSFEREE’S SIGNATURE

 

 

 

RV-F1317001 (Rev. 4-05)

RDA-692

VEHICLE SERVICES DIVISION

TENNESSEE DEPARTMENT OF REVENUE

ODOMETER DISCLOSURE STATEMENT

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.

I,

SELLER OR TRANSFEROR’S NAME (PLEASE PRINT)

certify to the best of my knowledge that the odometer reading on the vehicle described below is the actual mileage of the vehicle unless one of the following statements is checked:

ODOMETER READING (NO TENTHS)

1 I hereby certify that the mileage stated is in excess of the mechanical limits of the odometer.

2 The odometer reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY.

MAKE

MODEL

BODY TYPE

VEHICLE IDENTIFICATION NUMBER

YEAR

SELLER OR TRANSFEROR’S ADDRESS CITYSTATEZIP CODE

X

 

SELLER OR TRANSFEROR’S SIGNATURE

 

DATE OF THIS STATEMENT

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S NAME (PLEASE PRINT)

 

 

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S ADDRESS

CITY

STATE

ZIP CODE

X

 

 

 

 

 

BUYER OR TRANSFEREE’S SIGNATURE

 

 

 

RV-F1317001 (Rev. 4-05)

RDA-692

OWNER

TENNESSEE DEPARTMENT OF REVENUE

ODOMETER DISCLOSURE STATEMENT

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.

I,

SELLER OR TRANSFEROR’S NAME (PLEASE PRINT)

certify to the best of my knowledge that the odometer reading on the vehicle described below is the actual mileage of the vehicle unless one of the following statements is checked:

ODOMETER READING (NO TENTHS)

1 I hereby certify that the mileage stated is in excess of the mechanical limits of the odometer.

2 The odometer reading is not the actual mileage. WARNING - ODOMETER DISCREPANCY.

MAKE

MODEL

BODY TYPE

VEHICLE IDENTIFICATION NUMBER

YEAR

SELLER OR TRANSFEROR’S ADDRESS CITYSTATEZIP CODE

X

 

SELLER OR TRANSFEROR’S SIGNATURE

 

DATE OF THIS STATEMENT

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S NAME (PLEASE PRINT)

 

 

 

 

 

 

 

 

 

BUYER OR TRANSFEREE’S ADDRESS

CITY

STATE

ZIP CODE

X

 

 

 

 

 

BUYER OR TRANSFEREE’S SIGNATURE

 

 

 

RV-F1317001 (Rev. 4-05)

RDA-692

COUNTYCLERK