Federal and State law requires that you state the mileage in ... - MVA

6601 Ritchie Highway, N.E., Glen Burnie, Maryland 21062

Odometer Disclosure Statement

VR-197 (06-17)

Federal and State law 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, (print seller's name) certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked:

miles (no tenths)

K The mileage stated is in excess of its mechanical limits

K The odometer reading is not the actual mileage. Warning - odometer discrepancy

Make:

Model:

Year:

Body Type:

Vehicle Identification No.:

Seller's Signature:

Seller's Printed Name:

Seller's Street Address:

City:

State:

Zip Code:

Date of Statement:

Buyer's Signature:

Buyer's Printed Name:

Buyer's Street Address:

City:

State:

Zip Code:

White Copy - MVA Canary Copy - Seller Pink Copy - Buyer

For more information visit our website at mva. or call 410-768-7000. TTY for the hearing impaired: 1-800-492-4575.

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