Odometer Disclosure Statement

Federal law (and state law, if applicable) requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false statement may result in fines and/or imprisonment.

I, Demo Auto Sales, state that the odometer now reads 109,800 (no tenths) miles and to the best of my knowledge that it reflects the actual mileage of the vehicle described below, unless one of the following statements is checked.

I hereby certify that to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits.

I hereby certify that the odometer reading is NOT the actual mileage. WARNING: ODOMETER DISCREPANCY.

Year

2015

Make

Kia

Model

Soul Base

Body

Wagon

VIN

KNDJN2A27F7100001

Stock #

26-0011

Color

Red

Transferor (seller)

Demo Auto Sales

1500 W Sample St, Sioux Falls, SD 57106

(555) 555-0142

Dealer license #D-10482

Transferee (buyer)

Rosa Martinez

1348 Maple St Sioux Falls, SD 57107

Seller signatureDate

Buyer signatureDate

Date of statement: Apr 16, 2026

Federal odometer law: 49 U.S.C. 32705 and 49 CFR Part 580. Some states require their own form or electronic title disclosure.