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State of Nebraska

Department of Motor Vehicles

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BILL OF SALE*
DATE OF SALE
(MO/DAY/YEAR)

I,

in consideration of the payment of the sum of $
Transferor (Seller) PLEASE PRINT

acknowledge receipt of payment from

and do hereby sell and
Transferee (Buyer) PLEASE PRINT

transfer ownership of the motor vehicle described below:
Vehicle Information

Year

Make

Model

VIN

Transferor Information

Transferee Information

Full Name

Full Name

Address

Address

City State Zip

City State Zip

Phone Number

Phone Number

Transferor’s (Seller) Signature

Transferee’s (Buyer) Signature

Seller warrants that he/she is the lawful owner of the motor vehicle described above and that it is free and clear of all
liens, security agreements, encumbrances, claims, demands and charges.
Subscribed and sworn before me the

day

of

Subscribed and sworn before me the

day

of
Signature of Notary Public or Designated County Official

Signature of Notary Public or Designated County Official

My