"Odometer Disclosure Statement Form" - Texas

What Is a Texas Odometer Disclosure Statement?

A Texas Odometer Disclosure Statement is a form required when ownership of a vehicle is transferred from its seller to its new owner. The statement is a method to prevent tampering with the odometer because the falsification of odometer readings is punished by federal and state law and may lead to imprisonment.

Alternate Names:

  • Texas Odometer Disclosure;
  • Texas Odometer Statement.

A Texas Odometer Disclosure Statement Template can be downloaded below.

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How to Fill Out a Texas Odometer Disclosure Statement?

A Texas Odometer Disclosure Statement should be filled out in the following way:

  1. State the seller's name and that the seller certifies that the information listed in this statement is true and accurate.
  2. Select the appropriate box to make it clear whether the mileage amount listed is one of the following:
    • The mileage listed is complete and accurate to the best of your knowledge;
    • The mileage listed is in excess of this vehicle's mechanical limits;
    • The mileage listed is not the actual mileage and that it has been altered. ​Be aware that this will create an odometer discrepancy.
  3. Input the mileage at the time the vehicle was sold.
  4. Input the make, model, year, and body type. You will also have to add your VIN, license state, and license plate number.
  5. Fill in the buyer's name and address. Have the buyer sign the document.
  6. Fill in the seller's name and address. Have the seller sign the document.
  7. If there will be witnesses have them input their name and signature at the bottom of the document. It can be wise to have witnesses to your Texas Odometer Disclosure to verify its contents and verify the information that has been stated in it for an additional layer of protection for the buyer and the seller.

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Texas Odometer Disclosure
Statement
Federal and State law requires that you state the mileage in connection with the
transfer of ownership. Failure to complete or providing a false statement may result in
fines and/or imprisonment.
I, ______________________ , certify to the best of my knowledge that the odometer
reading is:
❏ The actual mileage of the vehicle to the best of my knowledge;
❏ In excess of its mechanical limits;
❏ Not the actual mileage. ​ W arning - odometer discrepancy.
Mileage at the time of sale is ________________________________.
_____________________
_____________________
_____________________
M ake
Body
Year
_________________________________
_________________________________
M odel
VIN
_________________________________
_________________________________
Last Plate State
Last Plate Number
The Buyer and Seller acknowledge that the motor vehicle is being sold without any
representations ("as-is").
Buyer's Name __________________ Buyer's Signature _______________________
Buyer's Address _______________________________________________________
Seller's Name __________________ Seller's Signature ________________________
Seller's Address ________________________________________________________
First Witness Signature __________________________
First Witness Printed Name _______________________
Second Witness Signature ________________________
Second Witness Printed Name _____________________
Texas Odometer Disclosure
Statement
Federal and State law requires that you state the mileage in connection with the
transfer of ownership. Failure to complete or providing a false statement may result in
fines and/or imprisonment.
I, ______________________ , certify to the best of my knowledge that the odometer
reading is:
❏ The actual mileage of the vehicle to the best of my knowledge;
❏ In excess of its mechanical limits;
❏ Not the actual mileage. ​ W arning - odometer discrepancy.
Mileage at the time of sale is ________________________________.
_____________________
_____________________
_____________________
M ake
Body
Year
_________________________________
_________________________________
M odel
VIN
_________________________________
_________________________________
Last Plate State
Last Plate Number
The Buyer and Seller acknowledge that the motor vehicle is being sold without any
representations ("as-is").
Buyer's Name __________________ Buyer's Signature _______________________
Buyer's Address _______________________________________________________
Seller's Name __________________ Seller's Signature ________________________
Seller's Address ________________________________________________________
First Witness Signature __________________________
First Witness Printed Name _______________________
Second Witness Signature ________________________
Second Witness Printed Name _____________________