Form HSMV82996 "Application for Motor Vehicle Dealer/Auto Auction or Customer Odometer Affidavit" - Florida

What Is Form HSMV82996?

This is a legal form that was released by the Florida Department of Highway Safety and Motor Vehicles - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2011;
  • The latest edition provided by the Florida Department of Highway Safety and Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HSMV82996 by clicking the link below or browse more documents and templates provided by the Florida Department of Highway Safety and Motor Vehicles.

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Download Form HSMV82996 "Application for Motor Vehicle Dealer/Auto Auction or Customer Odometer Affidavit" - Florida

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STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
MOTOR VEHICLE DEALER/AUTO AUCTION OR
CUSTOMER ODOMETER AFFIDAVIT
YEAR: ___________________________________________
MAKE: __________________________________________
TITLE NUMBER: __________________________________
VIN: _____________________________________________
1. This certifies that upon physical inspection of the vehicle listed above,
I/we find that this vehicle has a five digit odometer and the box should
be checked stating the vehicle mileage is "in excess of its mechanical
limits."
2. This certifies that upon physical inspection of the vehicle listed above,
I/we find that this vehicle has a six digit odometer that is over 99,999
miles and should state "actual mileage" on the title when issued.
3. This certifies that upon physical inspection of the vehicle listed above,
I/we find this vehicle to have a six digit odometer that is over 99,999
miles, and should state "actual mileage" on the title when issued.
The box stating "exceeds mechanical limits" was checked in error.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE
FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
_________________________
_______________________
Name of Dealer/Auction or Customer
Signature of Title Clerk or Customer
HSMV 82996 (Rev. 0711) S
www.flhsmv.gov
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
MOTOR VEHICLE DEALER/AUTO AUCTION OR
CUSTOMER ODOMETER AFFIDAVIT
YEAR: ___________________________________________
MAKE: __________________________________________
TITLE NUMBER: __________________________________
VIN: _____________________________________________
1. This certifies that upon physical inspection of the vehicle listed above,
I/we find that this vehicle has a five digit odometer and the box should
be checked stating the vehicle mileage is "in excess of its mechanical
limits."
2. This certifies that upon physical inspection of the vehicle listed above,
I/we find that this vehicle has a six digit odometer that is over 99,999
miles and should state "actual mileage" on the title when issued.
3. This certifies that upon physical inspection of the vehicle listed above,
I/we find this vehicle to have a six digit odometer that is over 99,999
miles, and should state "actual mileage" on the title when issued.
The box stating "exceeds mechanical limits" was checked in error.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE
FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.
_________________________
_______________________
Name of Dealer/Auction or Customer
Signature of Title Clerk or Customer
HSMV 82996 (Rev. 0711) S
www.flhsmv.gov