Form 48-7104 "Power of Attorney With Odometer Disclosure" - Arizona

What Is Form 48-7104?

This is a legal form that was released by the Arizona Department of Transportation - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2005;
  • The latest edition provided by the Arizona Department of Transportation;
  • 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 48-7104 by clicking the link below or browse more documents and templates provided by the Arizona Department of Transportation.

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Download Form 48-7104 "Power of Attorney With Odometer Disclosure" - Arizona

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POWER OF ATTORNEY
with Odometer Disclosure
Clear
www.azdot.gov
48-7104 R07/05
Vehicle Identification Number
Year
Make
Body Style
Attorney-In-Fact (individual or organization you wish to act for you in this matter)
Federal and State law require that the transferor/seller states the mileage upon transfer of ownership. Providing a false
statement may result in fines and/or imprisonment. The Transferor/Seller appoints the Attorney-In-Fact above to sign all papers
and documents required to secure the title, and further grants the authority to endorse and transfer title thereto, and to disclose
the mileage, for the vehicle described above, exactly as stated in the following disclosure.
Odometer Reading (no tenths)
Mileage in excess of the odometer mechanical limits.
miles
kilometers
NOT Actual Mileage, WARNING – ODOMETER DISCREPANCY.
I certify to the best of my knowledge that the odometer reading is the actual mileage unless one of the boxes above is checked.
Seller Name (printed)
Seller Signature
Name must be printed by hand.
Street Address
City
State
Zip
Notary or MVD Agent Signature
Acknowledged before me this date.
Date
County
State
Commission Expires
I am aware of the above odometer certification made by the seller.
Buyer Name (printed)
Buyer Signature
Name must be printed by hand.
POWER OF ATTORNEY
with Odometer Disclosure
Clear
www.azdot.gov
48-7104 R07/05
Vehicle Identification Number
Year
Make
Body Style
Attorney-In-Fact (individual or organization you wish to act for you in this matter)
Federal and State law require that the transferor/seller states the mileage upon transfer of ownership. Providing a false
statement may result in fines and/or imprisonment. The Transferor/Seller appoints the Attorney-In-Fact above to sign all papers
and documents required to secure the title, and further grants the authority to endorse and transfer title thereto, and to disclose
the mileage, for the vehicle described above, exactly as stated in the following disclosure.
Odometer Reading (no tenths)
Mileage in excess of the odometer mechanical limits.
miles
kilometers
NOT Actual Mileage, WARNING – ODOMETER DISCREPANCY.
I certify to the best of my knowledge that the odometer reading is the actual mileage unless one of the boxes above is checked.
Seller Name (printed)
Seller Signature
Name must be printed by hand.
Street Address
City
State
Zip
Notary or MVD Agent Signature
Acknowledged before me this date.
Date
County
State
Commission Expires
I am aware of the above odometer certification made by the seller.
Buyer Name (printed)
Buyer Signature
Name must be printed by hand.