The disclosure normally lives in the assignment block on the back of the title, and this form is what you use when it cannot. Two pages: three tick-box questions for the seller, two for the buyer, and a page of definitions that is the clearest thing the department publishes about what seventy per cent actually means. A private seller who has a title in hand and a clean car will usually never touch it - which is exactly why the cases where you do need it are worth knowing.
Written against 411108 (07-26), issued under Iowa Code s. 321.69 and 761 Iowa Admin. Code 400.43.
The 07-26 revision changed which book the value comes from. It now names the JD Power Car Book Values; the department's How to Sell a Vehicle page still sends sellers to the NADA Official Used Car Guide for the same number. If the two disagree on your car, use the one the form you are signing names.
Two documents, and they are not the same thing. Take the blank 411108 from the iowadot.forms.govos.com copy so you get the revision that is current today.
This is all 2 pages of the actual 411108, 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
Page 1 of 2. The disclosure itself: the seller's three questions in Section 1, the buyer's two in Section 2, and the two signature lines at the foot.Page 2 of 2. The department's definitions page - the worked seventy per cent example, the list of vehicles the disclosure does not apply to, and what counts as a transfer by operation of law.
Field by field
Every line, in the order you meet it
1
You fill this in
Printed Seller / Transferor Name
Your name in the certification sentence at the top, before the vehicle boxes.
Watch out: The sentence you are completing says the disclosure is true and correct for the vehicle below. Read the whole line before you write in it - it is a certification, not a header.
2
You fill this in
Year, Make, VIN
Three boxes. The VIN is the only one that has to be exact to the character.
Watch out: Copy the VIN from the title rather than the windscreen. A single wrong character makes the disclosure attach to a vehicle that is not the one you sold.
3
You fill this in
Question 1: salvage, rebuilt or flood
Whether you know the vehicle is now or was ever titled salvage, rebuilt or flood in Iowa or anywhere else. Yes sends you to question 3.
Watch out: This one asks what you know, not what the title says. A car you bought cheap out of state with a story attached is exactly the case the question was written for.
4
You fill this in
Question 2: the seventy per cent question
Only if question 1 was no. Whether damage before or during your ownership cost more than seventy per cent of the vehicle's fair market value before it was damaged.
Watch out: The form works an example: a vehicle worth $20,000 damaged, repaired for $15,000, is a yes. Compare the repair against what it was worth beforehand, not against what you are selling it for.
5
You fill this in
Question 3: what the title shows
Whether the current certificate of title shows prior damage. There is no equivalent box in the assignment area on the back of an Iowa title.
Watch out: Look at the front of your own certificate before you answer. A damage designation prints on the face, and this question is asking whether you have read it.
6
The buyer fills this in
Leave Section 2 alone
The buyer's half, for four situations: a non-resident seller, a transfer by operation of law, a sale on pre-July-2021 title stock, and a buyer filing Form 411109 because you could not be found.
Watch out: If you are handing this to a buyer along with the car, the only mark you make below your own signature is nothing at all.
7
You fill this in
Sign and date
The seller's line, with the date. No notary.
Watch out: The form's own note beside the line - seller does not need to sign if only Section 2 is completed - is there because a buyer filing this alone would otherwise be stuck waiting for a signature they cannot get.
8
The buyer fills this in
The buyer signs underneath
Their signature and date, on the line below yours.
Watch out: This form has to be provided to the buyer and surrendered to the county treasurer during the title application, so the copy they sign is the copy that gets filed.
At a glance
What goes where
On the form
What to put in it
Printed Seller / Transferor Name
At the top, inside the certification sentence, before any of the questions.
Year, Make, VIN
Three boxes identifying the vehicle. Nothing about model or body type is asked.
Section 1, question 1
Whether you know the vehicle is now, or was previously, titled as salvage, rebuilt or flood in Iowa or any other state. Yes skips you to question 3.
Section 1, question 2
Only if you answered no to question 1: whether damage during or before your ownership cost more than seventy per cent of the vehicle's fair market value before it was damaged.
Section 1, question 3
Whether you know the current certificate of title shows there was prior damage. This one has no counterpart on the back of the title.
Section 2, questions 1 and 2
The buyer's half, for a vehicle bought from a non-resident, taken by operation of law, or sold on pre-July-2021 title stock that asks about fifty per cent instead of seventy.
Seller's / Transferor's signature and date
With the department's own parenthesis beside it: seller does not need to sign if only Section 2 is completed.
Buyer's / Transferee's signature and date
Underneath yours. On this form the buyer signs whichever section was used.
What gets this one rejected
•Using it on a vehicle more than seven model years old. Iowa Code s. 321.69 exempts those outright, along with motorcycles, motorised bicycles, special mobile equipment, and trucks and truck tractors rated at 16,000 pounds or more.
•Answering question 2 after answering yes to question 1. The form sends you straight past it - the instruction on question 1 reads skip to question #3.
•Working the seventy per cent off what you paid. It is measured against the fair market value before the damage, and the 07-26 revision points at the JD Power Car Book Values for that figure.
•Guessing at repair cost. The form asks for the retail cost of repairing the vehicle including labour, parts and other materials if it has not been repaired, or the actual retail cost if it has - and all repair charges including sales tax must be included.
•Leaving it out when the title is not to hand. The department's own condition for completing Section 1 is that the Iowa title is not available, which is the commonest reason a private seller ends up on this form at all.
Rules that decide whether it is accepted
•Seven model years, and the department's own website says eight. The form says seven model years old or newer. So does the statute, by exempting vehicles more than seven model years old. So does 761 IAC 400.43(2), which sets the exempt line at the current year minus eight - in 2026 that is model year 2018 and older. Iowa DOT's Title a Vehicle page says eight years old or newer, twice. Work from the form.
•Seventy per cent now, fifty per cent on old paper. Iowa titles issued before 1 July 2021 print the fifty per cent version in their assignment block. If a seller discloses on one of those, the buyer completes Section 2 of this form to say whether the damage was actually seventy or higher.
•A separate statement is required whether or not you are a dealer. The form says so in its own words under OTHER REQUIREMENTS: all sellers, including private sellers, must provide this separate damage disclosure statement if it is required to the buyer at or before the time of sale.
•The county checks anyway. 761 IAC 405.6 requires a computer records check before a title is issued, and the department and county treasurers can apply a damage designation from that search whether or not either party disclosed anything.
•Getting it wrong is a fraudulent practice. Printed on the form in capitals: a person who knowingly makes a false damage disclosure statement commits a fraudulent practice.
