Fillable Printable Form MV-950 - Affirmation of Repossession and Bill of Sale - New York

Form MV-950 - Affirmation of Repossession and Bill of Sale - New York

Federal and state laws require that the mileage of the vehicle described above be specified upon transfer of ownership. Failure to do so, or

not telling the truth about mileage, may result in fines and/or imprisonment.

I, _______________________________________________________ state that the odometer now reads ______________________ miles

The vehicle described above was repossessed in _______________________ on ______________ from the borrower who was in default

of a security contract dated _______________ . On ________________ , ______________________________________________ was

authorized to sell the above vehicle (if applicable).

Section 425(1) of the Vehicle and Traffic Law requires that, when a motor vehicle or motorcycle is repossessed, proper notification must

be provided to the parties listed below, within 24 hours.

(Month/Day/Year)

(State)

(Auctioneer)

PROPER NOTICE HAS BEEN GIVEN TO THE FOLLOWING PARTIES (list names and addresses):

Date Notified

New York State Department of Motor Vehicles

AFFIRMATION OF REPOSSESSION AND BILL OF SALE

www.dmv.ny.gov

VEHICLE IDENTIFICATION NUMBER

PLATE NUMBER

YEAR MAKE MODEL

City

PURCHASER:

ODOMETER DISCLOSURE STATEMENT

Print Last Name,

First, M.I.

Date of SalePrice

Paid

ZIP Code

Number and

Street Address

State

Police Agency Name Address

Address

Commissioner of Motor Vehicles (enter Name

of Motor Vehicles office notified)

Borrower/Current Owner Name

(other than lienholder)

Address

Other Name

Address

STATE LAST REG STATE LAST TITLED

Apt. No.

Under the penalties of perjury, I affirm that I have complied with Section 425(1) of the New York State Vehicle and Traffic Law (see page 2) and/or any

applicable laws in the state where the vehicle was repossessed, pertaining to the repossession of the vehicle described above. I further affirm that, if there are

any other open perfected liens on the vehicle, and a lien release is not obtained, I have advised the purchaser of the outstanding liens

on the vehicle.

(Lender’s Signature)

Lender Signature

Purchaser Signature

The odometer on the vehicle described above has (check the appropriate box):



5 digits



6 digits



7 digits, not including tenths.

and (one of the following statements must be checked):



I certify that, to the best of my knowledge, this odometer reading reflects the “ACTUAL MILEAGE” as seen on the odometer of

the vehicle described above.



I certify that, to the best of my knowledge, the above-disclosed odometer reading “EXCEEDS MECHANICAL LIMITS”. (The mileage

is in excess of what the odometer is capable of recording.)



I certify that, to the best of my knowledge, the above-disclosed odometer reading is “NOT THE ACTUAL MILEAGE. WARNING:

ODOMETER DISCREPANCY.”

Lender – Print Name in Full

(do not include tenths of a mile)

DAMAGE DISCLOSURE STATEMENT

MV-950 (1/11)

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Business

Name

Last Name,

First, M.I.

Number and

Street Address

City

Number and

Street Address

Apt. No.

City

State ZIP Code

Apt. No.

INSTRUCTIONS



Lenders must complete boxes If Lender is selling vehicle, Purchaser information is required in boxes

BORROWER

LENDER

VEHICLE DESCRIPTION (includes motor vehicle or motorcycle, manufactured home* or boat * )



(*NOTE: This notification is not required when a manufactured home or boat is repossessed.)

IMPORTANT: Making a false statement, or failure to accurately disclose the salvage status of a vehicle, may subject

you to substantial civil fines, in addition to any penalties authorized by the Penal Law.

Check one box– I certify that, to the best of my knowledge, this vehicle wrecked, destroyed or damaged to such

an extent that the total estimate, or actual cost, of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident, and

for legal operation on the road or highways, is more than 75% of the retail value of the vehicle at the time of loss. (Checking the “has been

” box means

the vehicle must have an anti-theft examination before being registered, and that the title issued will have the statement “Rebuilt Salvage: NY” on it.)



has been



has not been

reset/clear

§ 425. Repossession of motor vehicle or motorcycle; garageman’s lien; notice to police. 1. Any person, firm or

corporation, or agent, employee or representative thereof, repossessing or retaking a motor vehicle or motorcycle pursuant to

the provisions of article nine of the uniform commercial code, or other authority of law, or any contract or agreement, shall,

immediately following such repossession or retaking, personally appear at a station house or other office of the police

department, or agency or officer performing like functions, in the locality wherein such repossession or retaking occurred,

give notice to such department, agency or officer of such repossession or retaking and thereafter and within twenty-four

hours personally deliver or mail by special delivery first class mail to the nearest motor vehicle district office, (a) notice of

such repossession or retaking in such form as the commissioner may require and (b) the number plates of such motor vehicle

or motorcycle. Notice of such repossession or retaking, including the name and address of the person, firm or corporation

repossessing or retaking the same, shall also be given within twenty-four hours thereof to the owner of such motor vehicle or

motorcycle, either personally or by registered or certified mail directed to such owner at his last-known address. Unless the

motor vehicle or motorcycle can be repossessed or retaken without breach of the peace, it shall be repossessed or retaken by

legal process, but nothing herein contained shall be construed to authorize a violation of the criminal law.

MV-950 (1/11)

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