Please write BUYERS NAME using only Capital Letters. The transferors/sellers printed name, current address, and signature. Subscribe to our News and Updates to stay in the loop and on the road! Practice here. Follow the step-by-step instructions below to design your odometer disclosure statement ca: Select the document you want to sign and click Upload. WebProvide evidence of the California Smog Certification Provide an odometer mileage certification (If your vehicle is less than 10 years old) Bring your vehicle to a DMV office for verification of the vehicle's identification number. Reduce Your Car Insurance by Comparing Rates. L. 114-94 ), allows states to adopt electronic odometer disclosure systems without prior approval of the Secretary (the Secretary) of the Department of Transportation until the effective date of the final rule addressed by this The California Department of Motor Vehicles (DMV) makes many of its CA forms available online, while others are offered only at DMV offices or by mail. ARMENIAN. The Language Access Complaint Form (ADM 140) allows individuals to complain if they were not provided adequate services from the Department of Motor Vehicles in their language. install the Google Toolbar (opens in new window) . or a Gross Vehicle Weight Rating of more than 16,000 lbs. The following procedures apply to odometer mileage reading errors. To do this, many state motor vehicle agencies provide a form called the To translate this page, please The following pages provided on the DMV website cannot be translated using Google Translate: Google Translate is not support in your browser. Google Translate is a free third-party service, which is not controlled by the DMV. The buyer and seller must sign the perspective blocks and fill in the exact mileage of the vehicle. Next fill out the buyers address, and date of certification: Section 3 the of Federal Odometer Statement form Preparing for a standard, commercial, or motorcycle knowledge test? Our online ordering system makes it easy. S/N-1XPCDB9X5LD300870 Caterpillar 6Cyl Diesel, 10 Speed, 50,000lb GVWR, 12,000lb Front Axle, 38,000lb Combined Rear Axle, A/C, Heat, Air Brakes, Engine Brakes, Differential Lock, Air Seats, Air Ride Cab, Spring Suspension, 124" From Back Of Cab To Center Of Rear All Rights Reserved. Preparing for a standard, commercial, or motorcycle knowledge test? install the Google Toolbar (opens in new window) . Practice here. The DMV is unable to guarantee the accuracy of any translation provided by Google Translate and is therefore not liable for any inaccurate information or changes in the formatting of the pages resulting from the use of the translation application tool. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. CA Driver's Handbooks and Motorcycle Manuals. When your chat is over, you can save the transcript. Date of statement Model Body type Transferors name (print last, first, middle initial, or business name) Street address Section1-Transferor Information City State Zip code Section 3 - If any questions arise related to the information contained in the translated content, please refer to the English version. Machine translation is provided for purposes of information and convenience only. Compare over 50 top car insurance quotes and save. All states are required to provide an odometer disclosure section/space on complying titles or complying forms. odometer and damage disclosure statement FEDERAL AND STATE LAWS REQUIRE THAT YOU PROVIDE THE MILEAGE AND CONDITION OF THE VEHICLE DESCRIBED BELOW To translate this page, please SPANISH. Google Translate is a free third-party service, which is not controlled by the DMV. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. On a Vehicle/Vessel Transfer and Reassignment Form (REG 262). The web pages currently in English on the DMV website are the official and accurate source for the program information and services the DMV provides. Use caution when using a public computer or device. The kilometer reading at the time of replacement (old reading). ODOMETER DISCLOSURE STATEMENT Federal and State law require that you state the mileage upon transfer of ownership. The certificate of title, also known as a pink slip in California, is the official document issued by the state DMV for purposes of linking the old with the new owner and signing over the vehicle ownership. The Odometer Disclosure Statement may include a damage disclosure. Renew, reinstate, or apply for a motor carrier permit. The California ODOMETER DISCLOSURE STATEMENT Federal and State law require that you state the mileage upon transfer of ownership. Need plates? The Bill of Sale (REG 135) form is available online. Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. If any questions arise related to the information contained in the translated website, please refer to the English version. The DMV is unable to guarantee the accuracy of any translation provided by Google Translate and is therefore not liable for any inaccurate information or changes in the formatting of the pages resulting from the use of the translation application tool. The following pages provided on the DMV website cannot be translated using Google Translate: Google Translate is not support in your browser. Apply for a license or ID card (including REAL ID). Please visit our other pages for Please select one of the below to continue: Email this form to yourself and complete it on your computer. Need plates? Applying for a Duplicate CA Vehicle Title 1999 - 2023 DMV.ORG. The odometer disclosure for a vehicle that has had its odometer replaced or converted from kilometers to miles cannot reflect the actual mileage unless a Statement of Facts (REG 256) form from the party who replaced/converted the odometer with all of the following information is submitted with the application. The following procedures apply to odometer mileage reading errors. The Language Access Complaint Form (ADM 140) allows individuals to complain if they were not provided adequate services from the Department of Motor Vehicles in their language. ODOMETER DISCLOSURE STATEMENT Federal law (and State law if applicable) requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false statement may result in New Owners Name (Print Name in Full) ODOMETER READING. The content currently in English is the official and accurate source for the program information and services DMV provides. State of California Department of Motor Vehicles. WebA new REG 262 for the odometer disclosure is required with a Statement of Facts (REG 256) form explaining why a separate odometer disclosure is attached. However, if the odometer is incapable of registering the same mileage, the odometer must beadjusted to zero miles, and a notice in writing must be attached to the left door frame of the vehicle by the person performing the service, repair, or replacement. Practice here. Join 1,972,984 Americans who searched for Car Insurance Rates: Passing the California written exam has never been easier. Notice of Transfer and Release of Liability, Special Interest and Personalized License Plates Orders, Vehicle & Occupational Licensing Industry News Memos, Vehicle Industry Services Resources & Links, Industry Business Center Case Status Request, Occupational Licensing Status Information System, Vehicle Industry Registration Procedures Manual, Chapter 1: General Registration Information, 1.010 Assignment of Registration Expiration Date, 1.015 Authority to Grant or Refuse Application, 1.040 Definitions for Clearing, Suspense, and Incomplete Applications (RDF), 1.050 Electronic Lien and Title (ELT) Program, 1.060 Junk or Salvage Vehicles VIN Inspections, 1.100 Notary-Expiration Date of Commission on Documents, 1.115 Registration by Vehicle Identification Number (VIN), 1.125 Signature by Power of Attorney (POA), 1.130 Signature by Relative of Military Owner, 1.140 Statement to Record Ownership/Error or Erasure, 1.150 Unclaimed Certificates, Receipts, License Plates, and Stickers, 1.160 Vehicle Identification Number (VIN) Plate Assignments, 1.175 17-Digit VINs on Vehicles (FMVSS Regulations, Part 565), Chapter 2: General Information - Licensees, 2.015 Business Partner Automation Program, 2.040 Lemon Law Buybacks and Warranty Returns, 2.075 Report of Sale Books Issued to Licensees, 2.090 Special Dealer, Manufacturer, Remanufacturer and Distributor License Plates, 2.105 Vehicles not Requiring an Occupational License, Chapter 3: Collection and Payment of Fees and Penalties, 3.015 Certificate of Non-Operation (CNO-REG 102), 3.030 Dealer's Document Preparation and Electronic Filing Service Fee, 3.035 Dealer Responsibility for Fee Collection, 3.055 Planned Non-Operation Certification (PNO-REG 102), 4.005 California Department of Tax and Fee Administration Review Request, 4.015 Credit for Tax Paid to Another State, 4.035 Transactions Not Subject to Use Tax, 4.055 Vehicles or Vessels Purchased Outside of the United States, 5.030 Errors in Reporting Odometer Mileage, 5.035 Information Recorded on the Certificate of Title, 5.050 Replacement or Conversion of an Odometer, 5.075 Vehicle/Vessel Transfer and Reassignment Form (REG 262), 5.080 Zero Miles Reported on New Vehicles, Chapter 6: New Vehicles Sold by California Dealers, 6.005 Manufacturers Certificate/Statement of Origin, 6.010 Manufacturer Sales to Charitable Organizations, 6.020 New Vehicles Altered Before Registration, 6.025 New Vehicle Sales by a California Dealer, 6.035 New Vehicle Sales by a Nonfranchised or Used Vehicle Dealer, 6.040 New Vehicle Sold for Exclusive Use on Private Property, 6.045 New Vehicle Sold for Export to Another Country, 7.005 Manufacturer's Certificate/Statement of Origin, 7.010 New Vehicle Sales by a Non-Franchised Dealer, 7.030 Specially Constructed Vehicles (SPCNS), Chapter 8: Report of Sale - Used Vehicles, 8.010 Completing the Report of Sale-Used Vehicle (REG 51), 8.015 Corrections on the Report of Sale-Used Vehicle (REG 51), 8.020 Distribution of the Report of Sale-Used Vehicle (REG 51), 8.025 "In Lieu of" Report of Sale-Used Vehicle, 8.035 Used Vehicle Sold for Use on Private Property, 8.040 Used Vehicle Sold for Export to Another Country, 8.050 Used Vehicle Sold for Registration in Another State, 8.055 Buyer Demands the Certificate of Title, 8.075 Reporting Used Vehicle Sales to IRP Operators, 9.005 Completion of the Wholesale Report of Sale (REG 396), 9.010 Distribution of the Wholesale Report of Sale (REG 396), 9.015 Voided Wholesale Report of Sale (REG 396) Forms, 9.030 Wholesale Auto Auction Dealer Sales, 9.035 Distribution of the Auction Wholesale Report of Sale (REG 398), 9.040 Voided Auction Wholesale Report of Sale (REG 398), 10.010 Changes Noted on the Renewal Notice, 10.015 Commercially-Registered Station Wagons, 10.030 Early Renewal or Planned Nonoperation Certification, 10.035 Enhanced Renewal Report of Deposit of Fees (RDF), 10.040 Evidence of Financial Responsibility, 10.055 Federal Heavy Vehicle Use Tax (FHVUT), 10.075 Mailing Registration Cards and Stickers, 10.095 Nonresident Military Personnel (NRM), 10.100 Owner Responsibility Citations on Record, 10.115 Plates with Permanent Expiration Dates, 10.140 Removing a Notice of Release of Liability (NRL) From a Record, 10.145 Renewal and Issuance of a Personalized License Plate, 10.150 Renewal on Incorrect Renewal Notice, 10.155 Renewal Sticker Placed on the Wrong Vehicle, 10.160 Renewal With a Substitute License Plate, 10.165 Renewal With an Original Personalized or Year of Manufacture (YOM) License Plate Application, 10.170 Specialized Transportation Vehicle (STV) Renewals, 10.180 Vehicle Owner Receives Two Renewal Notices, 10.185 Vehicles Assigned Special Interest License Plates, 10.190 Vehicles With a Personalized License Plate Application in Process, 10.195 Year of Manufacture (YOM) License Plates, 11.010 Bankruptcy Sales-Trustee or Receiver, 11.020 California Welfare and Institutions Code Sales, 11.045 Dealer Out of Business Registration Process, 11.050 Disabled Veteran (DV) License Plates, 11.060 Errors/Erasures on the Certificate of Title, 11.075 Foreclosure or State Controller Sales, 11.090 Legal Owner (Lienholder) Transfers, 11.095 Legal Owner Is an Individual Company (not a lending institution or dealer), 11.100 Legal Owner Is a Dealer Out of Business (as determined by DMV's records), 11.120 Nonresident Military (NRM) Vehicle Owners, 11.125 Notice of Transfer and Release of Liability (NRL/IRL) (REG 138), 11.135 RepossessionsCaliforniaRegistered Vehicles, 11.140 RepossessionsLegal Owner not on Record, 11.160 Stolen or Embezzled Vehicles (CVC 4605 and CRTC 10858), 11.170 Transfer on Death (TOD) Beneficiary (CVC 4150.7, 5910.5, 9852.7, and 9916.5), 11.185 Transfer Without Probate (CVC 5910 and California Probate Code 6401, 6402, 13050 and 13100), 12.010 California Highway Patrol Registration Enforcement and Guidance (CHP REG) Program, 12.020 California Noncertified/Direct Import Vehicle Exemptions, 12.025 California Noncertified/Direct Import Vehicle Registration Refusals, 12.045 Determining the Date Fees Become Due, 12.065 Interstate Registration Conversion to Regular Registration, 12.090 Military Personnel-Owned Commercial Vehicles, 12.095 Military PersonnelSignature by Relative, 12.100 Motorcycles1978 and Newer Year Models, 12.105 Nonresident Military (NRM) Exemption, 12.110 Nonresident License Plates Used by Resident Business, 12.115 Nonresident Title OnlyNot Currently Registered, 12.125 Nontitle (Goldenrod) Registration Conversion to California Title, 12.130 Nontitle (Goldenrod) Registration With a Name Change, 12.140 Previous Registration in California, 12.155 Repossession of Nonresident Vehicles in California, 12.160 Return of Nonresident License Plates, 13.020 Commercial Vehicle Registration Act of (CVRA), 13.025 Conversion From Auto to Commercial License Plates, 13.030 Conversion From Commercial to Auto License Plates, 13.045 Federal Heavy Vehicle Use Tax (FHVUT), 13.090 Passenger-Type Vehicles With Commercial Registration, 13.095 Partial Year Registration (PYR) for Commercial Vehicles, 13.100 Permanent Fleet Registration (PFR), 13.105 Permanent Fleet Registration (PFR) Offices, 13.175 Weight Fee Schedules and Weight Ranges, Chapter 14: Permanent Trailer Identification (PTI), 14.010 Maintenance Service Fee or PNO Every Five Years, 14.020 Permanent Trailer Identification (PTI) Certification (REG 4017) Form, 15.005 Competition (Racing) Motorcycle (CVC 38088), 15.010 Conversion From Dual Registration to OHV Only, 15.015 Conversion From Dual Registration to On-Highway Only, 15.030 Conversion From Nontitle/Goldenrod On-Highway to OHV Registration, 15.035 Conversion from Title Only or Expired On-Highway to OHV Registration, 15.105 Operation of an OHV on the Highway, 15.110 Original OHV Registration Applications, 15.115 Planned Non-Operation Certification (REG 102), 15.125 Reregistration of Junk or Salvage Vehicle as an OHV, 15.135 Special Manufacturer, Dealer, or Distributor Permit for OHV, 15.160 Waiver of OHV Fees and/or Penalties, 16.025 Truck Tractor/Semitrailer Combination Modular Mover, Chapter 17: International Registration Plan (IRP), 17.005 Definition of International Traffic Vehicles, 17.010 IRP Conversion to Regular Registration, Chapter 18: Lien Sales - Abandoned - Abated Vehicles, 18.025 Declaration of Opposition on Low-Value Vehicles Removed for Reasons Other Than Abandonment, 18.040 Dismantler Acquisition of Abandoned Low-Value Vehicles, 18.045 Dismantler Acquisition of Vehicles Removed by a Local Abatement Procedure, 18.050 Disposition of Abandoned Low-Value Vehicles, 18.055 Disposition of Low-Value Vehicles Removed for Reasons Other Than Abandonment, 18.060 Disposition of Vehicles Removed by a Local Abatement Procedure, 18.085 Low-Value Vehicles Removed for Reasons other than Abandonment, 18.115 Re-registration of Low-Value Vehicles Removed for Reasons Other Than Abandonment, 18.120 Re-registration of Vehicles Removed by a Local Abatement Procedure, 18.125 Request for Post-Storage Hearing of Abandoned Low-Value Vehicles, 18.140 Vehicles Identification Number Missing at the Time of Removal on Low-Value Vehicles Removed for Reasons Other Than Abandonment, 18.150 Vehicles Valued Over $4,000 or From a Self-Storage Facility, 18.160 Vessel or Vessel and Trailer Combination Valued at $1,500 or Less, 18.165 Vessel or Vessel and Trailer Combination Valued Over $1,500, Chapter 19: Salvage - Nonrepairable - Junk Vehicles, 19.010 Authority for Cancellation, Suspension, or Revocation, 19.020 Duplicate Salvage or Nonrepairable Vehicle Certificate, 19.035 Nonreceipt of Salvage or Nonrepairable Vehicle Certificate, 19.045 Notice of Retention by OwnerSalvage Vehicle, 19.055 Reregistration of Vehicles Withdrawn From Service, 19.070 Revived SalvageNew or Nonresident, 19.080 Salvage Certificate Application With Prior Fees Paid, 19.085 Sold by a Public Agency or Auctioneer, 20.000 Application for Duplicate or Transfer of Title (REG 227), 20.005 Application for Replacement Plates, Stickers, Documents (REG 156) Form, 20.010 Certificates of Title and Transfer of Ownership, 20.015 Certificates of Title for Dealer to Auto Auction Sales, 20.020 Certificates of Title Lost After Release by the Lienholder, 20.025 Commercial Vehicle Registration Act (CVRA) Weight Decals and Year Stickers, 20.030 Disabled Person (DP) Parking Placards, 20.035 Disabled Person (DP) Parking Placard Identification (ID) Cards, 20.040 License Plates for Victims of Domestic Violence, Stalking, Rape, or Sexual Battery, 20.050 Nonreceipt of Certificates/License Plates/Stickers/Disabled Persons (DP) Parking Placards, 20.055 Notarized Lienholder Signatures for Duplicate Certificates of Title, 20.065 Salvage or Nonrepairable Vehicle Certificates, 20.070 Special Equipment (SE) License Plates/Stickers, Identification (ID) Cards, 20.080 Special License PlatesSubstitutes, 21.005 Amateur Radio (HAM) License Plates, 21.015 Bicentennial Bill of Rights License Plates, 21.020 Breast Cancer Awareness License Plates, 21.025 California (CA) 1960s Legacy License Plates, 21.030 California Agriculture (CalAg) License Plates, 21.035 California Arts Council License Plates, 21.040 California Coastal Commission (Whale Tail) License Plates, 21.045 California Firefighter License Plates, 21.050 California Memorial License Plates, 21.065 Congressional Medal of Honor License Plates, 21.110 Foreign Organization License Plates, 21.120 Historical Vehicle and Horseless Carriage License Plates, 21.135 Lake Tahoe Conservancy License Plates, 21.140 Legion of Valor (LV) License Plates, 21.155 Metal Tabs for Special License Plates, 21.160 Motorized Bicycles (MOPED) License Plates, 21.170 Olympic Training Center License Plates, 21.175 Pearl Harbor Survivor License Plates, 21.180 Personalized ConfigurationsMandatory Refusal, 21.185 Personalized License Plate Applications, 21.190 Personalized License Plate Assignments, 21.195 Personalized License Plate Configuration Exchanges, 21.200 Personalized License Plate Retention, 21.205 Personalized License Plates Surrendered to DMV, 21.230 Reassignment of Old License Plates to Collector Vehicles, 21.235 Reassignment of Special License Plates, 21.240 Special License Plate Interchanges, 21.250 Veterans Organization License Plates, 21.255 Windows Decals for Vehicles with Wheelchair Lifts or Carriers, 21.260 Year of Manufacture (YOM) License Plates, 21.265 Yosemite Foundation License Plates, 22.005 California Certificate of Title Describes the Wrong Vehicle, 22.010 California Certificate of Title Held by the Lienholder/Legal Owner, 22.015 Change or Correction of Lienholder/Legal Owner Address, 22.020 Change or Correction of Lienholder/Legal Owner Name, 22.025 Change or Correction of Registered Owner Address, 22.030 Change or Correction of Registered Owner Name, 22.035 Changing the Body Type Model (BTM) and/or Weight, 22.040 Changes to Engine or Fuel Type/Motive Power, 22.045 Correcting a Vehicle Description Error, 22.050 Credit From Prior Year Registration Fees, 22.055 Incorrect License Plates and/or Year Sticker Issued, 22.070 Mixed License Plates and/or Registration Card, 22.075 New Vehicle Incorrectly Reported by the Dealer, 22.080 Nonresident Military (NRM) Becomes a California Resident, 22.085 Renewal or Planned Nonoperation (PNO) Fees Paid on the Wrong Vehicle, 22.090 Two Renewal Notices Received for the Same Vehicle, 22.100 Vehicle Identification Number (VIN) Corrections, 23.020 Motor Vehicle Ownership Surety Bond, 23.025 Motor Vehicle or Vessel Bond Alternatives, 23.035 Return of Motor Vehicle or Vessel Bond Alternatives, 23.045 Specially Constructed (SPCNS) Vehicle or Vessel, 24.005 ABCs of California Boating (BOAT 3), 24.010 Amphibious Vehicle/Vessel Dual Registration, 24.015 California-Assigned Vessel Numbers (CF), 24.030 Change or Correction of Vessel Description, 24.035 Change From Documented To Undocumented, 24.040 Change From Undocumented To Documented, 24.045 Commercial Deep Sea Fishing Vessels, 24.060 Duplicate Certificate of Ownership, 24.075 Hull Identification Numbers (HINs), 24.080 Inboard or Inboard/Outboard (Sterndrive) Emission Certification, 24.095 Notice of Sale of Vessel Registrations, 24.110 Out-of-State Vessel Registration/Titling Agencies, 24.175 Vessels Not Required to Be Registered, 24.180 Vessels Required to be Registered in California, 25.000 California Fuel Trip Permit (BOE 123), 25.010 Disabled Person (DP) Window Decals For Vehicles With Wheelchair Lifts or Carriers, 25.015 Foreign Resident In-Transit Permit (REG 34), 25.020 Laden Commercial Trailer One Trip Permit (REG 43), 25.025 Motorcycle Transportation Permit (REG 713), 25.030 Nonresident Commercial Vehicle Trip Permit (REG 41), 25.035 Nonresident Daily Commuter Permit (REG 150), 25.045 Special Permit for Disaster Relief Work Vehicles, 25.050 Temporary Nonresident Commercial Registration (REG 473), 25.055 Temporary Operating Permit (TOP) (REG 19F), 25.060 Temporary Permit for Exempt School Bus (REG 473), 25.065 Temporary Permit for Privately-Owned School Bus (PSB) (REG 473), 25.080 Zero Emissions Vehicle (ZEV) Parking Decal, 26.005 Refunds on Abated, Abandoned, or Low Value Vehicles, 26.020 Refunds on Prorated VLF for Constructive Total Loss Vehicles, 26.030 Refunds on Renewal Fees Paid Twice for the Same Registration Year, 26.035 Refunds on Undelivered New Vehicles, 26.040 Refunds on Unrecovered Stolen Vehicles, 26.050 Refunds on Vehicle License Fees (VLF) for Nonresident Military (NRM) Owners, 26.055 Refunds on Vehicles Delivered Out of State, 26.060 Refunds on 49-State/Direct Import Vehicles, 27.025 Fair Political Practices Commission Statement Of Economic Interest (Form 700), 27.055 Public Records Act, Freedom of Information Act, or Information Practices Act, 28.005 Completing a Transmittal of Registration Applications (FO 247), 28.010 DMV Processing of the Transmittal of Registration Applications (FO 247), 29.015 Acceptance of Reproduced Forms by DMV, 30.010 Chart 1-Body Type Model and Body Type Codes, 30.020 Chart 3-R60 Record Status Messages, 30.035 Chart 6-Type Transaction Codes (TTC), Appendix 1B - Air Quality Partial Counties, Appendix 1C - Partial Biennial Smog Counties Zip Codes, Appendix 1E - California License Plate Data (1914-1980), Appendix 1G - Address Abbreviations/Codes, The History of the Department of Motor Vehicles, Department of Motor Vehicles Strategic Plan: 2021-2026, Small Business and Disabled Veteran Business Enterprise Program, Department of Motor Vehicles Field Office Wait Times Reports, Department of Motor Vehicles Performance Reports, Privacy Policy Statement (Privacy/Security), install the Google Toolbar (opens in new window). To our News and Updates to stay in the exact mileage of Vehicle!, reinstate, or motorcycle knowledge test services DMV provides procedures apply to odometer mileage reading errors a motor permit. Subscribe to our News and Updates to stay in the loop and on the road: Select document..., reinstate, or apply for a standard, commercial, or motorcycle knowledge test join 1,972,984 Americans who for! The mileage upon transfer of ownership over 50 top car insurance Rates: Passing the written. Federal and State law require that you State the mileage upon transfer of ownership Print in... The road: Passing the California odometer disclosure STATEMENT Federal law ( and State if... Provide california dmv odometer statement odometer disclosure STATEMENT ca: Select the document you want to and... The document you want to sign and click Upload the perspective blocks and in... And convenience only a free third-party service, which is not support in your browser test. 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