Missouri Vehicle Bill of Sale
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Form

Purchaser(s)

5049

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Missouri Department of Revenue
Notice of Sale or Transfer

Name(s) (Last, First, Middle Initial)*

Address*

City*

State*

r
r

Driver License Number

Zip Code*

Inside City Limits
Outside City Limits (list county) _____________________________

Date of Birth (MM/DD/YYYY)

E-mail Address

Seller(s)

___ ___ / ___ ___ / ___ ___ ___ ___
Name(s) (Last, First, Middle Initial)*

Address

City

State

Dealer Number, if applicable

Vehicle

Select one:

r Motor Vehicle or Motorcycle

Title Number

Zip Code

r Trailer

r ATV

Year*

Make*

State

Sale Date (MM/DD/YYYY)*
___ ___ / ___ ___ / ___ ___ ___ ___

Instructions

Signature

Vehicle Identification Number (VIN)* Net Price (After Trade-In)*

I certify under penalties of perjury that the facts regarding this sale are true to the best of my knowledge knowingly submitting false information
about the sale of a vehicle is a Class C Misdemeanor.
Signature of One Purc