The mileage certification on its own sheet, for the transfers where the certificate's own odometer statement will not serve - a title that has no space left, an electronic title with no face to write on, or a correction to a reading already made. Its opening instruction is the clearest statement Indiana publishes of who owes the disclosure to whom: the seller of a motor vehicle must disclose the current mileage to a purchaser in writing upon transfer of ownership.
Written against State Form 43230 (R5 / 4-26), issued under IC 9-17-2-6; IC 9-18.1-3-1 and 49 CFR 580.
Where a branch has asked for this form as well as the certificate, the reading on both has to be the same number. Copying one figure onto two documents at two different moments is how a digit goes missing, and an odometer discrepancy follows a car for the rest of its life.
Two documents, and they are not the same thing. Take the blank State Form 43230 from the forms.in.gov copy so you get the revision that is current today.
This is the actual State Form 43230, rendered from the PDF the Indiana Bureau of Motor Vehicles publishes and completed end to end: letterhead, every field, and the blocks at the foot.
Amber — you write it
Grey — not yours to fill
Numbered — explained below
The whole sheet as published. Neither numbered statement is ticked, because the sentence above them already certifies the reading as actual mileage unless one of them is - and the purchaser band at the foot is deliberately empty, because that is the buyer's signature and it happens when they take their copy.
Field by field
Every line, in the order you meet it
1
You fill this in
I, ______
The printed names of all sellers on the first ruled line, spelled as the certificate spells them.
Watch out: This is the line the whole certification hangs off. A shortened first name here and a full one on the certificate is a mismatch somebody has to ask about.
2
You fill this in
residing at ______
Number and street, city, state and ZIP on the second ruled line.
Watch out: Your address, not the buyer's and not where the car has been kept. The purchaser has a block of their own further down.
3
You fill this in
The reading, in whole miles
The current figure in the box marked Miles (no tenths).
Watch out: Read it off the dash on the day of the handover. A reading taken a fortnight earlier and a car that has been driven since is a small lie that gets printed onto somebody else's title.
4
You fill this in
The two numbered statements
Tick one only if it is true: mileage in excess of its mechanical limits, or a reading that is NOT the actual mileage and should not be relied upon.
Watch out: The second one carries the words WARNING - ODOMETER DISCREPANCY into the buyer's record permanently. It is the right answer for a swapped cluster and the wrong answer for an instrument you simply do not trust.
5
You fill this in
The vehicle
Make, Model, Year and Body Type on one row, then the Vehicle Identification Number and the Transfer Date.
Watch out: Copy the identification number off the certificate rather than off the windscreen plate. Seventeen characters read through glass at arm's length is where a transposed digit comes from.
6
You fill this in
Sign and date it
Signature(s) of Seller(s) and the date, under the sentence about not holding the Bureau responsible for any discrepancy shown on the odometer reading.
Watch out: Only one of two sellers has to sign this particular form. That is a concession the certificate does not make, so do not read it as a general rule.
7
You fill this in
Fill in the purchaser's details for them
Printed name, address, city, state and ZIP in the PURCHASER'S INFORMATION band.
Watch out: Same spelling as the certificate's purchaser section. The two documents are read together and a different middle initial across them is a query, not a detail.
8
The buyer fills this in
The buyer's acknowledgement
Signature and date under the words I am aware of and acknowledge the above odometer certification made by the seller(s).
Watch out: Get it signed while they are standing in front of you, and take a photograph of it. Instruction 2 says they return a copy to you, and in practice nobody ever does unless it is done on the spot.
At a glance
What goes where
On the form
What to put in it
I, ______ residing at ______
Two ruled lines at the top: the printed names of all sellers, then the address of the seller as number and street, city, state and ZIP.
Miles (no tenths)
One box for the reading, labelled in the margin beside the certification sentence.
The two numbered statements
Statement 1 certifies the reading reflects the amount of mileage in excess of its mechanical limits. Statement 2 certifies the reading is NOT the actual mileage and should not be relied upon, under the bold words WARNING - ODOMETER DISCREPANCY.
Vehicle Make, Model, Year, Body Type
Four boxes on one row, then the Vehicle Identification Number with the Transfer Date beside it.
Signature(s) of Seller(s) and date
Under the sentence declining to hold the Bureau of Motor Vehicles or the Bureau of Motor Vehicles Commission responsible for any discrepancy shown on the odometer reading.
PURCHASER'S INFORMATION
A banded section at the foot: the purchaser signs and dates under the words I am aware of and acknowledge the above odometer certification made by the seller(s), then prints their name, address, city, state and ZIP.
What gets this one rejected
•Tenths of a mile. The label beside the box says no tenths, and a decimal reading is not the figure a branch will key.
•Both numbered statements ticked. They are alternatives - a reading past the mechanical limits is a different claim from a reading that cannot be relied on.
•Neither statement ticked when one is true. The sentence above them certifies actual mileage by default, so silence is itself a certification.
•An empty purchaser band. Instruction 2 says the purchaser must sign the disclosure statement, including printed name and address, and return a copy to the seller.
•Pencil, or a colour the branch cannot photocopy. Instruction 3 asks for the form to be completed in its entirety, in blue or black ink.
•A transfer date that disagrees with the date of sale on the certificate. The two documents describe one handover and a branch reads them side by side.
Rules that decide whether it is accepted
•One signature is enough on this one. Instruction 1 is unusual and worth knowing: if more than one person is a seller, only one seller is required to sign the written disclosure. The certificate's own seller section is not so forgiving.
•The purchaser owes you a copy back. Instruction 2 puts the obligation on them - sign, print, and return a copy to the seller. That returned copy is the only proof you kept of what the odometer said.
•It sits alongside the certificate, not instead of it. The BMV's own checklist asks for this form only where the odometer statement is not completed on the certificate of title or certificate of origin.
Every line here was read off State Form 43230 (R5 / 4-26) itself — the PDF is here — and off the Indiana Bureau of Motor Vehicles pages.
This is plain-language help with a form, not legal advice, and where our wording and the agency's differ,
theirs governs.
