How to fill out New York MV-103

The standalone version of the two disclosures that are normally printed on the back of the certificate. You need it when the certificate you are handing over has no disclosure section on it - an older title, or a transferable registration - and the DMV will not register the vehicle without one.

Written against MV-103 (5/25), issued under the federal odometer disclosure regulations at 49 CFR part 580, and the damage disclosure New York requires on every transfer. The mileage on this form, on the certificate and on the buyer's application all have to be the same number. They are read by different people at different desks, and a disagreement between them is the buyer's problem for about a week and then yours.

Two documents, and they are not the same thing. Take the blank MV-103 from the dmv.ny.gov copy so you get the revision that is current today, then print our MV-103 guide and keep it beside you while you fill theirs in.

Step 1 · the form itself Blank MV-103 — Odometer and Damage Disclosure Statement PDF at dmv.ny.gov · new tab Step 2 · how to fill it in Our filled-in MV-103 guide PDF · print and keep beside you

Filled in

What a completed one looks like

This is the actual MV-103, rendered from the PDF the New York State Department 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

A New York MV-103 filled in: an odometer reading of 104382, the six digits box ticked, certification 1 for actual mileage ticked, the has not been box ticked on the damage disclosure, a 2015 Nissan Rogue with identification number 5N1AT2MV6FC812743, and seller and new owner blocks signed, printed, addressed and dated 18 August 2026. — The actual MV-103 at revision 5/25. The two boxes people leave empty are both ticked here: six digits, which is what makes the reading interpretable, and the damage disclosure, which New York requires whatever the age of the car.

Field by field

Every line, in the order you meet it

1
You fill this in
Odometer reading
The reading exactly as the dashboard shows it, with no tenths, in the box at the top left.
Watch out: Read it on the day of the sale. A figure copied off an old inspection report is a false statement even when it was true once.
2
You fill this in
Which certification you are signing
One of three boxes: actual mileage, exceeds mechanical limits, or not the actual mileage.
Watch out: Exceeds mechanical limits means the odometer rolled past its last digit and started again - it does not mean the car has done a lot of miles. If the clock has been replaced or is broken, the third box is the honest one.
3
You fill this in
Five digits or six
How many digits the odometer displays, ignoring tenths.
Watch out: Count them on the dashboard rather than assuming. This is what turns a low reading on an old car from a suspicion into a documented rollover.
4
You fill this in
Damage disclosure
Has been, or has not been, damaged past 75% of the vehicle's retail value at the time of loss.
Watch out: Ticking has been means the buyer needs an anti-theft examination before the vehicle can be registered, and the new certificate will carry the rebuilt salvage statement. That is not a reason to tick the other box.
5
You fill this in
Vehicle description
Year, make, model, body type and the vehicle identification number across one strip.
Watch out: Copy the identification number from the certificate. This form gets stapled to a title application and read alongside it.
6
You fill this in
Seller block
Signature on the rule marked X, printed name in full, mailing address, city, state, ZIP and the date of statement.
Watch out: Print the name in full. This is a federal disclosure as well as a state one, and initials are not a name on either.
7
The buyer fills this in
New owner block
The buyer signs, prints, gives their address and dates it, acknowledging that they have seen the reported mileage.
Watch out: Their signature is the acknowledgement. Without it the form records what you told them but not that they heard it, and the DMV wants both halves.

At a glance

What goes where

On the form	What to put in it
The warning across the head	Set in capitals: federal and state laws require that you provide the mileage and condition of the vehicle when transferring ownership of it, and that giving false mileage information can mean fines and imprisonment.
Odometer reading (no tenths)	One box, top left. The instruction above it is to enter the odometer reading exactly as it appears on the vehicle's odometer, excluding tenths.
Five digits or six digits	A pair of boxes asking how many digits the odometer has, excluding tenths. It is what makes a rollover provable rather than arguable.
The three numbered certifications	Numbered 1, 2 and 3: the reading reflects the ACTUAL MILEAGE, it EXCEEDS MECHANICAL LIMITS because the odometer started over at zero, or it is NOT THE ACTUAL MILEAGE and carries an odometer discrepancy warning.
Damage disclosure - check one box	Has been, or has not been, wrecked, destroyed or damaged past 75% of the retail value of the vehicle at the time of loss. Above it sits a line about substantial civil fines and penalties under the Penal Law.
Vehicle description	Year, make, model, body type and the vehicle identification number, in one strip across the sheet.
Seller and new owner blocks	Each gets a signature rule, a printed name, a mailing address, city, state, ZIP and a date of statement. The buyer signs to acknowledge the reported mileage.

What gets this one rejected

•Rounding, or writing tenths. The box says no tenths and means the number as the odometer shows it.
•Ticking two certifications. It is one of the three, and the form says please check one.
•Leaving the damage box empty. The disclosure has no age limit in New York, and a missing one stops the registration rather than delaying it.
•Only the seller signing. The new owner signs the statement as well, which is the point of the acknowledgement - the buyer is confirming they were told.

Rules that decide whether it is accepted

•When you need this rather than the certificate. The disclosure is printed on the reverse of title certificates issued from 1994 onwards. If an older version of the title is used, the DMV requires the seller to give the buyer a completed statement on this form instead.
•It is also the salvage disclosure. For a vehicle eight model years old or newer the DMV will not register it or issue a new certificate unless the seller has completed, and the buyer has signed, the damage disclosure - either on the reverse of the certificate or attached on this form.

Every line here was read off MV-103 (5/25) itself — the PDF is here — and off the New York State Department 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.

Back to all New York seller paperwork, or what selling a car in New York involves.

How to fill out New York MV-103

What a completed one looks like

Every line, in the order you meet it

Odometer reading

Which certification you are signing

Five digits or six

Damage disclosure

Vehicle description

Seller block

New owner block

What goes where

What gets this one rejected

Rules that decide whether it is accepted

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