Transcription of ODOMETER DISCLOSURE STATEMENT - Home | KYTC
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ODOMETER DISCLOSURE STATEMENT - Home | KYTC
kentucky transportation CABINET DIVISION OF MOTOR VEHICLE LICENSING TC 96 5 Rev. 06/2015 Page 1 of 1 ODOMETER DISCLOSURE STATEMENT Instructions: Attach this form to your title and registration application documents and forward to your county clerk. Note: Federal law requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false STATEMENT may result in fines and imprisonment under KY ODOMETER law KRS SECTION 1: VEHICLE INFORMATION YEAR MAKE MODEL VIN BODY TYPE SECTION 2: TRANSFEROR/SELLER INFORMATION & STATEMENT NAME (Please print.) PHONE ( ) ADDRESS I, state that the ODOMETER now reads miles and to the (Transferor/Seller s name) (no tenths) best of my knowledge reflects the actual mileage of the vehicle described above unless one of the following statements is checked. I hereby certify that to the best of my knowledge the ODOMETER reflects mileage in excess of its mechanical limits.
kentucky transportation cabinet division of motor vehicle licensing tc 96‐5 rev. 06/2015 page 1 of 1 odometer disclosure statement
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