The Odometer Disclosure Statement (Form 78-015) is the Mississippi Department of Revenue (DOR) form on which the person transferring a vehicle states the odometer reading when ownership changes. Both federal law and state law require the transferor to state the mileage, and the form warns that failing to complete it or giving a false statement may result in fines and/or imprisonment. On FillingPDF you can fill out the form online and download or print the completed PDF; the form itself is published by the DOR at the official link on this page.
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What is 78-015?
The Odometer Disclosure Statement is the Mississippi form on which the transferor, the person giving up ownership of a vehicle, certifies the odometer reading at the time of the transfer. It is issued through the Mississippi Department of Revenue (DOR), Motor Vehicle Services.
The form is printed as Form 78-015-17-8-1-000, Rev(09/7). The transferor writes the mileage with no tenths and states that, to the best of their knowledge, it reflects the actual mileage of the vehicle described on the form. The vehicle is identified by make, model, body type, year and vehicle identification number.
Two statements can be checked when the reading cannot be relied on as the true mileage:
- (1) the reading reflects mileage in excess of the odometer's mechanical limits;
- (2) the odometer reading is not the actual mileage.
These boxes sit under the heading "WARNING - ODOMETER DISCREPANCY". The form also has a signature and address block for the transferee, the person receiving the vehicle. The page states that both federal and state law require the mileage statement in connection with the transfer of ownership, and that failure to complete it or a false statement may result in fines and/or imprisonment.
Who needs to file 78-015?
The transferor, the person transferring ownership of a vehicle, must state the mileage on this form. The form says that both federal law and state law require the transferor to do so in connection with the transfer of ownership.
The transferee, the person receiving the vehicle, also has a block on the form. The transferee prints their name as it appears on the assignment of the manufacturer's certificate of origin, or on the title, gives their address and signs.
The form does not describe any exemption from the mileage statement and does not say that anyone may sign for another person, so questions about those situations go to Motor Vehicle Services at the DOR. The contact details are printed at the bottom of the form.
When to file 78-015
The statement is made when ownership of the vehicle is transferred, because the form requires the transferor to state the mileage in connection with the transfer of ownership. Enter the odometer reading as it stands at that time and the date of the statement in the space provided. The form prints no separate deadline, so ask Motor Vehicle Services at 601-923-7200 about timing for a particular transfer.
How to fill out 78-015
Enter the odometer reading
In the sentence beginning "I, state that the odometer now reads (no tenths)", the transferor prints their name and writes the mileage as a whole number, with no tenths.
Check a discrepancy box if needed
Leave both boxes blank if the reading reflects the actual mileage. Check (1) if it reflects mileage in excess of the odometer's mechanical limits, or (2) if it is not the actual mileage.
Describe the vehicle
Enter the Make, Model, Body Type, Year and Vehicle Identification Number of the vehicle being transferred.
Complete the transferor's block
The transferor prints their name and enters their address: street, city or town, state and ZIP code. Add the date of statement.
Sign as transferor
The transferor signs in the Transferor's Signature space, beside the printed name.
Complete the transferee's block
Print the transferee's name exactly as it appears on the assignment of the manufacturer's certificate of origin, or on the title. Enter the transferee's street, city or town, state and ZIP code.
Sign as transferee
The transferee signs in the Transferee's Signature space and prints their name beside it.
Review, sign and download the PDF
Check the mileage, the vehicle details, the discrepancy boxes, names and addresses, then download or print the completed PDF from FillingPDF and obtain the signatures.
How to submit 78-015
The form prints no filing address, online portal or appointment rule of its own. It is completed and signed by the transferor and the transferee as part of the transfer of ownership. The only contact printed on it is for the DOR's Motor Vehicle Services:
- Mail: Motor Vehicle Services, P. O. Box 1383, Jackson, MS 39215
- Phone: 601-923-7200
- Fax: 601-923-7224
- Website: www.dor.ms.gov
Contact Motor Vehicle Services to confirm where the signed statement must go for your transfer. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels.
Common mistakes to avoid
- Writing tenths of a mile in the mileage space; the form asks for the odometer reading with no tenths.
- Leaving the statement incomplete or giving a false mileage; the form warns this may result in fines and/or imprisonment.
- Not checking statement (2) when the odometer reading is not the actual mileage of the vehicle.
- Not checking statement (1) when the reading reflects mileage in excess of the odometer's mechanical limits.
- Entering the transferee's name differently from the way it appears on the assignment of the manufacturer's certificate of origin, or on the title.
- Leaving out the vehicle identification number, year, make, model or body type in the vehicle description.
- Omitting the transferor's address, the date of statement or either signature block (transferor or transferee).
Frequently asked questions
What is an odometer disclosure statement?
An odometer disclosure statement is a signed statement of a vehicle's mileage made when ownership is transferred. Mississippi's Form 78-015 has the transferor state the odometer reading, with no tenths, and certify that it reflects the actual mileage unless a discrepancy box is checked.
Who has to complete the Mississippi odometer disclosure statement?
The transferor, the person transferring the vehicle, must state the mileage; the form says both federal and state law require this. The transferee prints their name and address and signs the transferee block.
What happens if I give a false mileage on the form?
The form warns that failing to complete it or providing a false statement may result in fines and/or imprisonment. The form does not describe the penalties in more detail, so ask Motor Vehicle Services if you have questions.
When should I check box (1) or box (2)?
Check (1) if the reading reflects mileage in excess of the odometer's mechanical limits. Check (2) if the reading is not the actual mileage. If neither applies, leave both unchecked and the statement certifies the reading as actual mileage.
Whose name goes in the transferee block?
The transferee's name must be entered as it appears on the assignment of the manufacturer's certificate of origin, or on the title. The transferee's street, city or town, state and ZIP code go below it.
Where do I send the Mississippi odometer disclosure statement?
The form prints no filing address. It prints the contact for Motor Vehicle Services: P. O. Box 1383, Jackson, MS 39215, phone 601-923-7200, fax 601-923-7224. Contact them to confirm where the signed statement goes for your transfer.
Can I fill out the odometer disclosure statement online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not affiliated with the Mississippi Department of Revenue, and does not file or submit the form; both parties still sign it.
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