___________________, the “principal,” of ______________________,herewith appoints _____________________ of _______________________, as their attorney in fact, to act in the place and stead and with the same authority as Principal would have to transfer the following motor vehicle, and to take any other necessary steps to transfer title the following motor vehicle:
Make: ___________
Model: ______________
Year: ___________
Body: ____________
Vehicle identification number: ________________________
IMPORTANT: Central regulations require this statement to be given to purchasers on sales of vehicles. An inaccurate or untrue statement may make you liable for damages to the buyer and there may also be civil or criminal penalties.
The odometer described above now reads ______________ miles.
Certify one of the following—please “XXX” the appropriate line before the correct statement:
___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the actual mileage of the vehicle described below.
___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above reflects the amount of mileage in excess of designed mechanical limits of 99,999 miles of the vehicle described below.
___________ I (we) certify that to the best of my (our) knowledge the odometer reading as stated above is NOT the actual mileage of the vehicle described below, and should not be relied upon….
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