The Odometer Disclosure Statement is a Nebraska DMV form on which a seller certifies a vehicle's odometer reading and identifies both the seller and the buyer. The form may only be used in five situations printed at its top, such as a Certificate of Title issued by court order or an application for a Storage-Repair Lien. On this page you can fill out the Odometer Disclosure Statement online on FillingPDF and download or print the completed PDF; the form itself is published by the Nebraska DMV at the link below.
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What is Odometer Disclosure Statement – Nebraska?
The Odometer Disclosure Statement is the Nebraska DMV form on which a seller certifies a vehicle's odometer reading when ownership is transferred in one of the five situations listed at the top of the form.
The form states that federal and state law require the seller to state the mileage in connection with the transfer of ownership. It also warns that failing to complete it, or giving a false statement, may result in fines and/or imprisonment.
It is a one-page statement with four blocks:
- Vehicle Description: year, make, model, body type and Vehicle Identification Number.
- Certification: the seller's printed or typed name and the odometer reading. The seller certifies, to the best of their knowledge, that the reading is the actual mileage unless one of two statements is checked: The mileage stated is in excess of mechanical limits or Reading is NOT actual mileage – WARNING ODOMETER DISCREPANCY.
- Seller Information and Buyer Information: name, address, city, state and ZIP for each party.
- Signatures: the seller's and the buyer's signature, each with a date.
The form is not a general-purpose mileage statement. It says it may only be used in the situations listed on it. The seller must keep a copy for 5 years.
Who needs to file Odometer Disclosure Statement – Nebraska?
The seller states the mileage on this form, and the buyer is identified and signs it too. The form says it may only be used when one of these situations applies:
- a Certificate of Title is to be issued by court order;
- a dealer has voided an assignment on a Manufacturer's Statement of Origin and is attempting to reassign;
- a law enforcement agency is making application for a Certificate of Title to an Abandoned Vehicle;
- an Affidavit of Transfer of Decedent's Motor Vehicle is being submitted and the previous Certificate of Title is not available;
- an application is being made for a Storage-Repair Lien.
If your transaction is not one of these five, the form says it may not be used. The form prints no rules about representatives or anyone signing for the seller or buyer, so ask the Nebraska DMV if someone else will sign.
When to file Odometer Disclosure Statement – Nebraska
The triggering event is the transfer of ownership of a vehicle in one of the five situations printed on the form. The form says federal and state law require the seller to state the mileage in connection with that transfer, so the statement is completed as part of the transaction itself. No separate due date is printed on it.
After it is completed, the seller must retain a copy of the statement for 5 years.
How to fill out Odometer Disclosure Statement – Nebraska
Confirm the form applies to you
Read the five situations at the top of the form and confirm your transaction is one of them. The form may only be used in those cases.
Describe the vehicle
Under VEHICLE DESCRIPTION, enter the Year, Make, Model, Body Type and the Vehicle Identification Number.
Enter the seller's name
In the certification sentence, print or type the seller's name on the line after "I,".
Enter the odometer reading
Next to Odometer Reading, enter the mileage shown on the odometer, which the seller certifies is the actual mileage to the best of their knowledge.
Check a statement if needed
Check The mileage stated is in excess of mechanical limits or Reading is NOT actual mileage – WARNING ODOMETER DISCREPANCY only if it applies. Leave both unchecked when the reading is the actual mileage.
Print the seller information
Under SELLER INFORMATION, print the seller's Name, Address, City, State and Zip.
Print the buyer information
Under BUYER INFORMATION, print the buyer's Name, Address, City, State and Zip.
Sign and date for both parties
The seller signs and dates on the Seller's Signature line and the buyer on the Buyer's Signature line.
Review, download and keep a copy
Check the mileage, the vehicle identification number and every name, then download or print the completed PDF from FillingPDF. The seller must retain a copy for 5 years.
How to submit Odometer Disclosure Statement – Nebraska
The form prints no mailing address, portal or office of its own, so it travels with the transaction it supports: the court-ordered title, the reassignment of a Manufacturer's Statement of Origin, the abandoned-vehicle title application, the Affidavit of Transfer of Decedent's Motor Vehicle or the Storage-Repair Lien application. Ask the Nebraska DMV where that transaction is handled; its forms are listed at https://dmv.nebraska.gov/forms.
Before you hand it over, the seller must keep a copy, because the form requires the seller to retain one for 5 years. Print the seller and buyer details legibly, as the form asks, and make sure both parties have signed and dated it.
FillingPDF lets you fill out and download the PDF; submission follows the Nebraska DMV's channels for your transaction.
Common mistakes to avoid
- Using the form for a transaction that is not one of the five situations printed at its top; the form says it may only be used in those situations.
- Leaving the odometer reading blank. The form says failure to complete it may result in fines and/or imprisonment.
- Entering a false mileage. The form warns that a false statement may result in fines and/or imprisonment.
- Not checking Reading is NOT actual mileage – WARNING ODOMETER DISCREPANCY when the reading is not the actual mileage.
- Not checking The mileage stated is in excess of mechanical limits when the odometer reading has passed its mechanical limits.
- Leaving the seller's or buyer's signature or date blank; each party has its own signature and date line.
- Writing names and addresses illegibly when the form says "Please Print" in both the Seller Information and Buyer Information blocks.
- Handing over the only copy. The seller must retain a copy of the statement for 5 years.
Frequently asked questions
What is an odometer disclosure statement?
The Odometer Disclosure Statement is a Nebraska DMV form on which a seller certifies a vehicle's odometer reading when ownership is transferred. The form says federal and state law require the seller to state the mileage with the transfer, and it identifies both seller and buyer.
When can I use the Nebraska Odometer Disclosure Statement?
Only in the five situations printed on the form: a title issued by court order; a dealer reassigning after voiding a Manufacturer's Statement of Origin assignment; a law enforcement application for an Abandoned Vehicle title; an Affidavit of Transfer of Decedent's Motor Vehicle without the prior title; or a Storage-Repair Lien application.
Who signs the Odometer Disclosure Statement?
Both parties. The form has a Seller's Signature line and a Buyer's Signature line, each with a date. The seller's printed or typed name also appears in the certification sentence that states the odometer reading.
What if the odometer reading is not the actual mileage?
Check the matching statement instead of leaving it unmarked. The form offers two: the mileage is in excess of mechanical limits, or the reading is NOT actual mileage, marked with a warning about an odometer discrepancy.
How long must the seller keep a copy of the form?
The seller must retain a copy of the statement for 5 years. This requirement is printed at the bottom of the form.
What happens if I don't complete it or give false mileage?
The form states that failure to complete it, or providing a false statement, may result in fines and/or imprisonment. It cites federal and state law as the basis for requiring the seller to state the mileage.
Can I fill out the odometer disclosure statement online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the form; the Nebraska DMV receives it only through the channels for your transaction.
Where do I send the Odometer Disclosure Statement?
The form prints no address or portal. It supports one of the five listed transactions, such as a title application or a Storage-Repair Lien application, so ask the Nebraska DMV where that transaction is handled. Its forms page is https://dmv.nebraska.gov/forms.
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