Federal Odometer Disclosure Statement Compliance Log

Tracks odometer disclosure completion for retail title transfers, including buyer and seller signatures, to support compliance with 49 CFR Part 580.

Transaction Details

• Transaction Date
  Date the retail title transfer was completed.
• Dealership or Business Name
  Legal business name responsible for the disclosure record.
• Stock or Deal Number
  Internal reference number for the transaction.
• Transaction Type
  Select the type of retail title transfer.

Vehicle Information

• Vehicle Year
  Model year of the vehicle.
• Vehicle Make
  Manufacturer name.
• Vehicle Model
  Model name or trim identifier.
• Vehicle Identification Number (VIN)
  17-character VIN for the vehicle.

Odometer Disclosure

• Odometer Reading
  Enter the current odometer reading without commas or decimals.
• Odometer Units
  Select the unit shown on the odometer.
• Odometer Status
  Select the disclosure statement that applies to this vehicle.
• Explanation or Remarks
  Provide a brief explanation if the odometer is not the actual mileage or exceeds mechanical limits.
• Disclosure Certification
  Required acknowledgment for the disclosure record.

Buyer and Seller Signatures

• Seller Name
  Name of the seller or authorized representative.
• Seller Signature
  Seller signature acknowledging the odometer disclosure.
• Seller Signature Date
  Date the seller signed the disclosure.
• Buyer Name
  Name of the buyer or authorized representative.
• Buyer Signature
  Buyer signature acknowledging receipt of the odometer disclosure.
• Buyer Signature Date
  Date the buyer signed the disclosure.

Audit Trail and Retention

• Record Retention Location
  Where the signed disclosure is stored, if applicable.
• Reviewed By
  Name of the compliance or title-processing reviewer.
• Review Date
  Date the record was reviewed for completeness.
• Exceptions or Notes
  Document any missing information, corrections, or exceptions for the audit trail.