SOUTH DAKOTA UNIFORM MILEAGE DISCLOSURE STATEMENT

SD EForm - 2020 V1

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SOUTH DAKOTA UNIFORM MILEAGE DISCLOSURE STATEMENT

FEDERAL AND STATE LAW REQUIRES THAT YOU DISCLOSE A VEHICLE'S ACTUAL MILEAGE ON EACH TRANSFER OF OWNERSHIP. Failure to complete or making a false disclosure may result in fines and/or imprisonment. Complete this disclosure statement if the vehicle being transferred is less than ten (10) years old and weighs less than 16,000 pounds.

Vehicle: _________________________________________________________________________________________________________________

Year

Make

Serial #

Title #

Odometer Reading is: _____________________ (check one) ___miles ___ kilometers, which is the actual vehicle mileage unless one of the (No Tenths)

following statements is checked.

Stated Mileage: ____ Exceeds Odometer's Mechanical Limits OR

____ Is not actual mileage ? Warning ? Odometer Discrepancy

Disclosure Certification: I, as seller, under penalty of South Dakota law, certify by my signature to the truth and accuracy of the disclosure statement.

_____________________________________________________________ ________________________________________________________

Typed Name of Seller

Typed Name of Purchaser

_____________________________________________________________ ________________________________________________________

Signature of Seller

Date of Sale Signature of Purchaser

Date of Sale

______________________________________________________________ _________________________________________________________

Seller's Address

Purchaser's Address

______________________________________________________________ __________________________________________________________

City

State

Zip Code

City

State

Zip Code

DMV-611 (7-08)

COPY DISTRIBUTION

WHITE ORIGINAL YELLOW DUPLICATE

-- Submit to DMV attached to title

-- Seller's copy

PRINT FOR MAILING CLEAR FORM

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