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The Vermont motor vehicle bill of sale form is a legal document provided by Vermont Department of Motor Vehicles for the transfer of the motor vehicle.
TA-VT-05 50M 07/2012 REB Vermont Telecommunications Relay Service Dial 711
Bill of Sale and Odometer Disclosure Statement
DEPARTMENT OF MOTOR VEHICLES
Agency of Transportation
120 State Street
Montpelier, Vermont 05603-0001
If the vehicle being sold is 9 years old or newer and you are not submitting a separate Odometer Disclosure
Statement, please complete the Odometer Disclosure Statement on the back of this form.
I / We(Seller(s)
(If a company, give company name)
hereby sell, assign or transfer ownership of the vehicle/vessel described below:
Vehicle/Vessel Identification Number
Odometer Reading (Vehicles only)
(Purchaser or Transferee)
M M D D Y Y Y Y Purchase Price
I/We also certify that the motor vehicle described above is:
IF VEHICLE IS SALVAGE, SALVAGE AND REBUILT OR TOTALED THIS SECTION MUST BE COMPLETED:
Salvage Salvaged and Rebuilt Declared a total loss by insurer
Any personwho sells trades or offers for sale or trade any interest in a salvaged, salvaged and rebuilt or totaled vehicle shall disclose the fact that the vehicle has been
salvaged, salvaged and rebuilt or totaled to a prospective purchaser both orally and in writing before a sale, trade or transfer is made. Written disclosure that the vehicle has
been salvaged, salvaged and rebuilt or totaled, in addition to being disclosed on the certificate of title as required by this subchapter, shall also be conspicuously disclosed on
any bill of sale, transfer, purchase or other agreement.
Failure of the seller to provide the notices required by this section shall result in the seller being required, at the optio
n of the buyer, to refund to the buyer the purchase price,
including taxes, license fees and similar governmental charges.
This information has been conveyed to the purchaser, both orally and in writing in accordance with 23 V.S.A. Sections 2093 (b) (c), Salvaged, totaled and rebuilt vehicles.
If this section completed new owner sign:
The vehicle/vessel is free of all liens and encumbrances. Statements and warrants made herein are certified under penalty of
23 V.S.A. Sections 202, 203, 2082 & 3829 (4).
If vehicle is jointly owned, both owners must sign.
Seller's Signature - if company, Authorized Representative (include title)
Seller’s Phone Number
Buyer’s Signature - if company, Authorized Representative (include title)
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