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In accordance with all applicable statutes, administrative rules and regulations, I certify that the purchase price of the above-described motor vehicle was $ ______________, which included all accessories and/or attachments with no trade-in allowance or any other transaction. I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.
PURCHASER CERTIFICATION
PURCHASER NAME (print) PURCHASER SIGNATURE DATE (mm/dd/yyyy)
SELLER CERTIFICATIONIn accordance with all applicable statutes, administrative rules and regulations, I certify that the selling price of the above-described motor vehicle was $ ______________, which included all accessories and/or attachments with no trade-in allowance or any other transaction. I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.
SELLER NAME (print) SELLER SIGNATURE DATE (mm/dd/yyyy)
VEHICLE INFORMATION
SALE DATE (mm/dd/yyyy)VEHICLE IDENTIFICATION NUMBER (VIN) COLOR
YEAR (more than 5 years old) MAKE MODEL BODY TYPE
VEHICLE PRICE CERTIFICATION (VEHICLE MUST BE MORE THAN 5 YEARS OLD)
Purpose: This form is used by individuals (not motor vehicle dealers) to certify the purchase price of a motor vehicle more than 5 years old in order to obtain a vehicle title.
Instructions: Seller or Purchaser completes Vehicle Information section and signs the appropriate Certification section.
SUT 1 (06/10/2014)
