This is the form that gets used when you cannot be found. A buyer who has a car and no mileage statement from you, and who has genuinely tried to reach you, swears this affidavit instead - and the title Iowa then issues records the mileage as not actual, for good. It is on a seller's page because it is the consequence of leaving the odometer box empty, and because it is the document that turns your paperwork lapse into a permanent brand on the car.
Written against 411099 (09-21), issued under 761 Iowa Admin. Code 400.40(2), sworn statement in lieu of a transferor's odometer disclosure.
If a buyer contacts you asking for a mileage statement weeks after the sale, giving them one is almost always better for both of you than letting this affidavit be sworn. Form 411077 takes five minutes and leaves the vehicle's mileage record intact; this one does not.
Two documents, and they are not the same thing. Take the blank 411099 from the iowadot.forms.govos.com copy so you get the revision that is current today.
This is the actual 411099, rendered from the PDF the Iowa Department of Transportation, Motor Vehicle Division 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
Rendered from the department's own published form and completed the way a buyer would complete it, because there is no seller's line on it at all. Grey marks the notary block, which somebody else fills in. Every name and address is invented for the sample.
Field by field
Every line, in the order you meet it
1
The buyer fills this in
State of Iowa, County of
The venue for the oath - the county where it is being sworn, not where the car was bought.
Watch out: It is filled in by the affiant or the notary. If a buyer sends you this to sign, they have misread the form: your name goes on it, your signature does not.
2
The buyer fills this in
The reason the seller could not be found
A written account of the good-faith attempt to locate the transferor, with room to continue on the back.
Watch out: This is the paragraph a county treasurer actually reads. Dates, methods and outcomes carry it; a single line saying he moved does not.
3
The buyer fills this in
Odometer Mileage
The reading on the vehicle, certified by the buyer rather than by you.
Watch out: It will be recorded as not actual whatever it says, because nobody who drove the car is certifying it.
4
The buyer fills this in
One of the two notations
Not actual mileage - warning odometer discrepancy, or exceeds mechanical limits of odometer. The form says you must check one.
Watch out: There is no actual mileage option on this form, and that is deliberate. An unwitnessed reading cannot be certified as true.
5
The buyer fills this in
Make and V.I.N.
Two boxes. The year is not asked for, which is unusual for an Iowa vehicle form.
Watch out: The VIN is what ties the affidavit to the record. It has to match the certificate being surrendered, character for character.
6
The buyer fills this in
Name and last known address of the transferor
Your name and the address they tried, written by them.
Watch out: Whatever you put on the bill of sale is what appears here. That is one more reason to give a real address at the point of sale.
7
The buyer fills this in
Signature of Affiant, then the notary
The buyer signs, and a notary completes the subscribed-and-sworn block with a seal.
Watch out: Once it is sworn and filed, the not actual notation is on the vehicle record and no later form takes it off.
At a glance
What goes where
On the form
What to put in it
State of Iowa, County of
The venue block at the top. It is a sworn statement, so it opens like one.
The reason the transferor could not be located
A free-text block, several lines, with the form's own note that the reverse side or an additional page can be used.
Odometer Mileage
The reading the buyer certifies, taken from the vehicle in front of them.
A tick, and then one of two notations
The form requires one of the statements to be marked: not actual mileage - warning odometer discrepancy, or exceeds mechanical limits of odometer.
Make of Vehicle and V.I.N.
Two boxes. This form does not ask for the year.
Name of Transferor (Seller)
You, named by the buyer, in an affidavit you are not signing.
Last Known Address of Transferor (Seller)
The address they tried. Whatever you wrote on the bill of sale is what tends to end up here.
Signature of Affiant (Owner)
The buyer signs it. There is no seller signature line anywhere on the form.
Subscribed and sworn to before me, seal, Notary Public
It is notarised, and the notary block is the last thing on the page.
What gets this one rejected
•A seller filling it in. There is no line for you on this form. It is sworn by the person who acquired the vehicle, and the whole premise is that you could not be reached.
•Using it to skip an awkward conversation. The affiant has to state the reason they were unable to locate the seller, in writing, under oath.
•Filing it without a reading. The form requires an odometer mileage figure and one of the two notations ticked; a blank notation is an incomplete certification.
•Expecting the title to come out clean. 761 IAC 400.40(2) says the subsequent title issued from the sworn statement will record not actual mileage.
•Reaching for it on a vehicle that never needed a disclosure. The form prints its own limit: any vehicle of model year 2011 or newer requires disclosure until 31 December 2030, and nothing is required if the vehicle has a registered gross weight rating of more than 16,000 pounds.
Rules that decide whether it is accepted
•It is the buyer's remedy, and it costs the car something. The not actual notation goes onto the Iowa record permanently. It follows the vehicle through every later sale and it comes off the resale value of a car whose mileage was probably perfectly genuine.
•Good faith is the test. The rule requires that the transferee has attempted in good faith to contact the transferor. A single unanswered text is not obviously that; a returned letter to the address on the bill of sale is closer.
•It also indemnifies the county. The affiant agrees to warrant and defend the title and to protect and hold harmless the county treasurer from any damages arising from issuing it. That is the price of the shortcut.
•There is a matching form for the damage disclosure. Form 411109 does the same job for a missing damage statement, and the two are often filed together by the same buyer for the same reason.
•The way to make sure it never gets used is boring. Fill in the mileage box on the back of the title before the car leaves, and photograph the completed block. Iowa's own suggestion for proof of sale is a copy of that side of the certificate.
