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NAME OF DEALERSHIP <br />PRINTED NAME OF PURCHASER(S) <br />SIGNATURE <br />PRINTED NAME OF PURCHASER(S) <br />ADDRESS <br />PRINTED NAME <br />CITY STATE. ZIP <br />POSITION <br />PRINTED NAME <br />I AM AWARE OF THE ODOMETER STATEMENTS <br />MADE BY THE SELLER(S) <br />DEALER NUMBER <br />SIGNATURE OF PURCHASER <br />DATE OF SALE <br />SIGNATURE OF PURCHASER <br />REASSIGNMENT BY DEALER AND ODOMETER CERTIFICATION <br />NAME OF DEALERSHIP <br />PRINTED NAME OF PURCHASER(S) <br />SIGNATURE <br />PRINTED NAME OF PURCHASER(S) <br />ADDRESS <br />PRINTED NAME <br />CITY STATE ZIP <br />POSITION <br />PRINTED NAME <br />I AM AWARE OF THE ODOMETER STATEMENTS <br />MADE BY THE SELLER(S) <br />DEALER NUMBER <br />SIGNATURE OF PURCHASER <br />DATE OF SALE <br />SIGNATURE OF PURCHASER <br />THIRD REASSIGNMENT BY DEALER AND ODOMETER CERT1FICAT {ON <br />NAME OF DEALERSHIP <br />PRINTED NAME OF PURCHASER(S) <br />SIGNATURE <br />ADDRESS <br />PRINTED NAME <br />CITY STATE ZIP <br />POSITION <br />I AM AWARE OF THE ODOMETER STATEMENTS <br />MADE BY THE SELLER(S) <br />DEALER NUMBER <br />SIGNATURE OF PURCHASER <br />DATE OF SALE <br />SIGNATURE OF PURCHASER <br />NO ADDIT! NAL R <br />'SI <br />MENTS PERMITTED ON 7 S. E OOD I11Tri . <br />Federal and State law requires that the seller state the mileage in connection with the transfer of ownership. Failure to complete or providing a false statement may result in fines and /or <br />imprisonment. (RETAIN COPY FOR 5YEARS.) <br />The undersigned, being the owner of the vehicle described within the Certificate of Title, hereby sells and assigns all right, title and interest in and to said Certificate of Title and the <br />vehicle described therein to the following named purchasers. <br />I certify to the best of my knowledge the odometer reading is the actual mileage of the vehicle unless one of the following statements is ch2k 1 <br />CAUTION ❑ 1. The mileage stated is in excess of its mechanical limits. U <br />READ CAREFULLY <br />BEFORE YOU <br />CHECK A BLOCK <br />ODOMETER READING <br />I certify to the best of my knowledge the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked: <br />❑ 1. The mileage stated is in excess of its mechanical limits. <br />❑ 2. The odometer reading is not the actual mileage. WARNING — ODOMETER DISCREPANCY. <br />ODOMETER READING <br />FIRST REASSIGNMENT BY DEALER AND ODOMETER CERTIFICATION <br />NO <br />TENTHS <br />NO <br />TENTHS <br />I certify to the best of my knowledge the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked: <br />❑ 1. The mileage stated is in excess of its mechanical limits. <br />❑ 2. The odometer reading is not the actual mileage. WARNING — ODOMETER DISCREPANCY. <br />ODOMETER READING <br />LIENHOLDER'S NAME <br />ADDRESS <br />NO <br />TENTHS <br />CAUTION <br />READ CAREFULLY <br />BEFORE YOU <br />CHECK A BLOCK <br />CAUTION <br />READ CAREFULLY <br />BEFORE YOU <br />CHECK A BLOCK <br />❑ 2. The odometer reading is not the actual mileage. WARNING — ODOMETER DISCREPANCY. <br />LIENHOLDER TO BE RECORDED <br />CITY <br />t <br />Nebraska residents must make application for title within 30 days of the date of <br />ebraska purchase. Please visit our website at www.dmv.ne.gov for application forms and <br />additional information. <br />ANY ALTERATION OR ERASURE vows THIS TITLE <br />PLID <br />307847 <br />STATE <br />ZIP <br />