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Bill of Sale and Odometer Disclosure St
Department of Motor Vehicles

120 State Street
Montpelier, Vermont 05603-0001

Agency of Transportation

802.828.2000

dmv.vermont.gov

If the vehicle being sold is 9 years old or newer and you are not submitting a separate Odometer Disclosure Statement,
please complete the Odometer Disclosure Statement on back of this form.
I / We

hereby sell, assign or transfer
ownership of the vehicle or
vessel described below

(Seller(s) (If a company, give company name)

Year

Make

Model

Body/Hull Type

Color

Vessel Length
ft.

Vehicle/Vessel Identification Number (VIN/HIN)

in.

Odometer Reading (Vehicles only, no tenths)

 Miles  Kilometers
 Hours

New Owner

New Co-Owner

to:
on: Date

for: $

 No
Has this vehicle failed an emissions test
and been granted a time extension waiver in the past
?
12Yes
months
NOTE:A vehicle may not have two (2) consecutive time extension waivers. See avip.vermont.gov for more information.
If Vehicle is Salvage, Salva