BILL OF SALE FOR MOTOR VEHICLE **TO BE FILLED OUT BY SELLER** Model yr. Make Model no./name Body style Color ________ _____ ______________ ___________ ______ Odometer reading Vehicle Ident. Number Date of Purchase ________________ _____________________ ________________ Seller's Reg. No. Have you previously filed application for title for ________________ this vehicle: Yes___ No___ Seller's Name:_____________________ Street and No.________________ City or Town:______________________ State:________________________ AS OWNER OF THIS VEHICLE, I HEREBY TRANSFER OWNERSHIP TO; Buyer's Name:______________________ Street and No. _______________ City or Town:______________________ State:________________________ For the Sum of $_________________ I purchased this vehicle from:_____________________________________ Name _______________________________ ______________________ __________ Street and Number City or Town State I DECLARE UNDER THE PENALTIES OF PERJURY THAT THE STATEMENTS HEREIN CONTAINED ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. __________________________________ Seller SWORN TO AND SUBSCRIBED BEFORE ME THIS_______________day of ______ 20__. ___________________________________ Notary Public - Justice of Peace My Commission Expires: ____________ THIS VEHICLE MUST BE TAKEN TO,IN STATES WHERE REQUIRED, THE APPROPRIATE REGISTRY OFFICE, LOCAL POLICE STATION, STATE POLICE BARRACKS OR M.D.C. POLICE STATION FOR VEHICLE IDENTIFICATION NUMBER INSPECTION BEFORE DELIVERY TO BUYER. Form 215