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Purchase Agreement
Seller Buyer
Name ________________________________ Name ________________________
Co-owner_____________________________ Co-owner_____________________
Seller’s Address _______________________ Address ______________________
City _________________________________ City _________________________
State _____________Zip Code ___________ State___________Zip Code ______
Description of Vehicle Being Sold
Year _________________Make ______________________Color __________________
Model Description ________________________________________________________
Body Style ______________________________________________________________
(2 Dr/4Dr, # of cylinders, etc)
VIN __________________________State Title ___________Mileage______________
Disclosure & Warranty
The seller certifies that the odometer reading of this vehicle is correct to their knowledge, and that the seller
has not modified the odometer, disconnected it, or rolled back the mileage during their ownership.
Lienholder
Seller certifies that title will be transferred to the BUYER at time of final transaction.
Seller certifies to the BUYER if there is a LIENHOLDER, the title will be released.
Name of Lienholder ____________________________Account # _________________
Address ______________________________________Phone_____________________
BUYER certifies LIENHOLDER to be added to the title.
Selling Price of Vehicle $___________________________
(____________________________________________________________________________________)
Written Dollar Amount
Signatures
SELLER and BUYER declare under the penalties of perjury that the statements herein contained are
true and correct to the best of their knowledge and belief.
_________________________ _______________________ ___________________
Signature of SELLER #1 Signature of SELLER #2 Date
___________________________ __________________________ ______________________
Signature of BUYER #1 Signature of BUYER #2 Date


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