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| Motor Vehicle only |
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____________________, the “principal,” of ______________________, herewith appoints _____________________ of _______________________, as their attorney in fact, to act in the place and stead and with the same authority as Principal would have to transfer the following motor vehicle, and to take any other necessary steps to transfer title the following motor vehicle: Make: ___________ Model: ______________ Year: ___________ Body: ____________ Vehicle identification number: ________________________ IMPORTANT: Federal regulations require this statement to be given to purchasers on sales of vehicles. An inaccurate or untrue statement may make you liable for damages to the buyer and there may also be civil or criminal penalties. The odometer described above now reads ______________ miles. Certify one of the following—please “XXX” the appropriate line before the correct statement: ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the actual mileage of the vehicle described below. ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the amount of mileage in excess of designed mechanical limits of 99,999 miles of the vehicle described below. ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above is NOT the actual mileage of the vehicle described below, and should not be relied upon. Certify one of the following—please “XXX” the appropriate line before the correct statement: __________ I (we) certify that the odometer of the vehicle described above was not altered, set back, or disconnected while in my (our) possession, and I (we) have no knowledge of anyone else doing so. __________ I (we) certify that the odometer was altered for repair or replacement purposes while in my (our) possession, and that the mileage registered on the repaired or replaced odometer is identical to that before such service. __________ I (we) certify that if the repaired or replacement odometer was incapable of registering the same mileage, that it was reset to zero, and that the mileage on the original odometer or the odometer before repair was __________________ miles. The sales price of the vehicle is: $ ______ (________________________ & ____/100 dollars) ___________________________________________________ ____________________ By Authorizer of Power of Attorney STATE OF __________________ COUNTY OF __________________ ____________________ personally appeared before me and acknowledged the execution of this power of attorney for the purposes set forth therein. Dated: _______________________________ __________________________________________ Notary Public My Commission Expires on: Power of Attorney, Motor Vehicle only ____________________, the “principal,” of ______________________, herewith appoints _____________________ of _______________________, as their attorney in fact, to act in the place and stead and with the same authority as Principal would have to transfer the following motor vehicle, and to take any other necessary steps to transfer title the following motor vehicle: Make: ___________ Model: ______________ Year: ___________ Body: ____________ Vehicle identification number: ________________________ IMPORTANT: Federal regulations require this statement to be given to purchasers on sales of vehicles. An inaccurate or untrue statement may make you liable for damages to the buyer and there may also be civil or criminal penalties. The odometer described above now reads ______________ miles. Certify one of the following—please “XXX” the appropriate line before the correct statement: ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the actual mileage of the vehicle described below. ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the amount of mileage in excess of designed mechanical limits of 99,999 miles of the vehicle described below. ___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above is NOT the actual mileage of the vehicle described below, and should not be relied upon. Certify one of the following—please “XXX” the appropriate line before the correct statement: __________ I (we) certify that the odometer of the vehicle described above was not altered, set back, or disconnected while in my (our) possession, and I (we) have no knowledge of anyone else doing so. __________ I (we) certify that the odometer was altered for repair or replacement purposes while in my (our) possession, and that the mileage registered on the repaired or replaced odometer is identical to that before such service. __________ I (we) certify that if the repaired or replacement odometer was incapable of registering the same mileage, that it was reset to zero, and that the mileage on the original odometer or the odometer before repair was __________________ miles. The sales price of the vehicle is: $ ______ (________________________ & ____/100 dollars) ___________________________________________________ ____________________ By Authorizer of Power of Attorney STATE OF __________________ COUNTY OF __________________ ____________________ personally appeared before me and acknowledged the execution of this power of attorney for the purposes set forth therein. Dated: _______________________________ __________________________________________ Notary Public My Commission Expires on: |
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