Automobile Fraud: Appendix B to Part 580 Disclosure Form for Title
ODOMETER DISCLOSURE STATEMENT
Federal law (and State law, if applicable) 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 state that the odometer now reads _________ (no tenths) miles and to the best of my knowledge that it reflects the actual mileage of the vehicle described herein, unless one of the following statements is checked.