The mileage sheet Nebraska mostly refuses. Since 1999 the odometer certification belongs on the certificate of title or the MSO and no separate attachment will be accepted - except in the five situations this form lists across its own top: a title issued by court order, a dealer reassigning after voiding an MSO assignment, a law enforcement agency titling an abandoned vehicle, an Affidavit of Transfer of Decedent's Motor Vehicle where the previous title cannot be found, and a Storage-Repair Lien application. A private seller meets exactly one of those with any regularity - the decedent case - and this page shows the form completed for it. Reaching for this sheet in an ordinary sale, because the title's own odometer section felt cramped, produces a document the county will not take.
Written against Odometer Statement (Rev 7/2017), issued under Neb. Rev. Stat. s. 60-192 and 49 CFR pt. 580; accepted by counties only in the five cases listed on the form.
This form asks for the seller's name three times in three registers - printed in the certification sentence, printed in the seller information block, signed at the foot - and the county compares all three against the affidavit or court order the statement rides with. In the decedent case, sign it the way the DMV's format for representatives runs: the owner's name, then by, then your own, then your capacity.
Two documents, and they are not the same thing. Take the blank Odometer Statement from the dmv.nebraska.gov copy so you get the revision that is current today, then print our Odometer Statement guide and keep it beside you while you fill theirs in.
This is the actual Odometer Statement, rendered from the PDF the Nebraska Department of Motor Vehicles, Driver and Vehicle Records 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 PDF and completed for the one case where a private person ordinarily files it: a decedent's vehicle claimed by affidavit with the previous title missing. The successor certifies the reading and the buyer half stays empty, because in that transaction the title issues to the successor and there is no purchaser to acknowledge anything. Amber is the certifying successor's; grey is the half this use of the form never touches. Every name and number is invented and the VIN identifies no vehicle.
Field by field
Every line, in the order you meet it
1
You fill this in
Confirm you are in one of the five cases
Court order, voided MSO assignment, abandoned vehicle, decedent's vehicle without its title, or a storage-repair lien. The list is printed at the top of the form.
Watch out: Outside those five, stop - the county will not accept a separate sheet, and the odometer section on the certificate is where your certification belongs.
2
You fill this in
Vehicle description and the VIN boxes
Year, make, model, body type, and the VIN at one character per printed box.
Watch out: Take the VIN from the registration or the vehicle's own plate if the title is the thing that is missing - a transposed character binds your sworn mileage to a car that does not exist.
3
You fill this in
Your name, inside the certification
Printed or typed where the sentence asks, before the reading.
Watch out: In the decedent case, use the representative format the DMV prescribes - the estate's name, by, your name, your capacity - so the statement matches the affidavit it accompanies.
4
You fill this in
The reading
Whole miles as the dial shows on the day you complete the statement.
Watch out: Read it that day, not from memory or an old service invoice. The certification sentence says to the best of my knowledge, and the number is the knowledge.
5
You fill this in
The two checkboxes, usually neither
Excess of mechanical limits for a rolled-over dial; the discrepancy warning for a reading you know is not the true mileage. Left unchecked, the sentence certifies actual mileage.
Watch out: Checking the discrepancy box is honest where it is true and permanent either way - the notation follows the vehicle onto every later Nebraska title.
6
You fill this in
Seller information, and buyer information when there is a buyer
Printed names and full addresses for each party to the disclosure.
Watch out: In the decedent-affidavit case the buyer block stays empty because the title issues to the successor making the statement. In the other four cases, the receiving party completes it.
7
You fill this in
Sign, date, and keep a copy for five years
Signature and date at the foot, then the capital-letter instruction: seller must retain a copy of this statement for 5 years.
Watch out: Five years is statutory, not advisory - and the copy is what answers a mileage dispute long after the county has filed the original.
At a glance
What goes where
On the form
What to put in it
Vehicle Description
Year, make, model and body type, then the VIN on its own line of seventeen boxes, one character per box.
I, (Print or Type Seller's Name)
The person certifying, named inside the certification sentence before the reading appears.
Odometer Reading
The mileage in a boxed field. The sentence around it certifies the reading as actual mileage unless one of the statements below is checked.
The mileage stated is in excess of mechanical limits
First checkbox - the dial has rolled over its maximum and started again.
Reading is NOT actual mileage - WARNING ODOMETER DISCREPANCY
Second checkbox, for a reading the certifier knows is wrong by more than calibration error.
Seller Information
Printed name, address, city, state and zip for the certifying party.
Buyer Information
The receiving party's matching block. In the decedent case there is often no buyer at all - see the sample.
Seller's Signature and Date; Buyer's Signature and Date
Two signature lines at the foot, above the retention rule printed in capitals: seller must retain a copy of this statement for 5 years.
What gets this one rejected
•Attaching it to an ordinary private sale. The form's own header limits it to five uses, and the county's instruction since January 1999 is that odometer certification will be accepted only on the Certificate of Title or MSO - the title's own section does this job.
•Using it on an exempt vehicle. A 2010-or-older model, a vehicle over 16,000 pounds gross rated capacity, or a motorcycle built without an odometer certifies nothing - a disclosure that was never required is a statement you did not have to make.
•Checking the discrepancy warning because the mileage seems high. Not actual mileage is knowledge that the reading is wrong by more than calibration error; excess of mechanical limits is a rolled-over dial. High is neither.
•A reading in kilometres. Nebraska requires the seller to convert a metric cluster to miles - one kilometre is 0.621 miles - and the buyer to acknowledge the converted figure.
•Discarding your copy once the county is satisfied. The retention line is printed in capitals on the form and s. 60-192 backs it: the transferor keeps a true copy for five years from the transaction.
Rules that decide whether it is accepted
•Federal and state law both stand behind it. The warning block across the form's top: failure to complete, or providing a false statement, may result in fines and/or imprisonment. Nebraska's own s. 60-192 sets out the same three statements the checkboxes carry.
•The decedent case is the one private families meet. When a successor files the Affidavit of Transfer of Decedent's Vehicle and the previous certificate is not available, the DMV requires this statement in the packet - it is the only route by which the mileage gets onto the new title.
•A notation, once made, is permanent. Not Actual and Exceeds Mechanical Limits must be carried onto every future title once recorded, and Exempt is a one-way door - after a title records Exempt, no later title may carry a mileage for that vehicle.
•A repaired odometer has its own protocol. A replacement cluster is set to the old mileage; if it cannot be, it is set to zero and the owner must request the DMV's Odometer Notice sticker recording the date and prior mileage - and the vehicle sells as Not Actual thereafter.
•Errors are corrected by a different, notarised form. A wrong reading discovered after filing is not fixed here - the county's Odometer Correction Statement requires both original parties, both signatures notarised, and a copy goes to the State Patrol's fraud division.
