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How to fill out South Dakota Form 1021

The mileage disclosure belongs inside the assignment on the back of the certificate - the Procedures Manual's line is that federal odometer regulations require that the odometer statement is completed on the title reassignment. Form 1021 is the separate sheet for the transfers where the title cannot carry it: a duplicate application, a car whose title is held electronically by a lender, a sale being papered where the certificate has run out of room. Its instruction sets the current test in one sentence - complete this disclosure statement if the vehicle being transferred is less than 20 years old and weighs less than 16,000 pounds - which is the rule that replaced the ten-year one at the end of 2020.

Written against Form 1021 (no revision printed), issued under South Dakota Department of Revenue, Motor Vehicle Division, under SDCL 32-3-30.1 and the federal Truth in Mileage Act, 49 CFR part 580. Do not use this sheet to avoid writing in the assignment. Where the certificate is in your hands, the disclosure goes on the title itself - that is what federal law and the manual both require, and a county treasurer meeting a title with an empty odometer statement and a loose Form 1021 will ask why. The separate sheet is for the cases where the title genuinely cannot carry the entry: an electronic title held by a lender, a duplicate application, a sale run through a power of attorney. The department may refuse to transfer the title or issue a new title if the disclosure on the certificate is not completed.

Two documents, and they are not the same thing. Take the blank Form 1021 from the sddor.seamlessdocs.com copy so you get the revision that is current today, then print our Form 1021 guide and keep it beside you while you fill theirs in.

Filled in

What a completed one looks like

This is the actual Form 1021, rendered from the PDF the South Dakota Department of Revenue, Motor Vehicle Division publishes and completed end to end: letterhead, every field, and the blocks at the foot.

A completed South Dakota Odometer Disclosure, Form 1021, for a 2015 Chevrolet Equinox LT. The vehicle block carries the year, make, model, vehicle identification number and title number. The odometer reading is entered as 108,472 with the Miles box ticked and the Actual mileage statement ticked. The seller block names Marlene D. Tschetter of Brookings, South Dakota with a date of sale of 08/19/2026, and the purchaser block names Orval J. Bjornson of Watertown, South Dakota with the same date. Both signature lines are left blank.
Completed for a 2015 model, which sits squarely inside the twenty-year window the form describes. Both signature lines carry no field in the department's markup and are left for pen; the two date-of-sale boxes do, and both are filled with the same date the assignment carries.
Field by field

Every line, in the order you meet it

  1. 1
    You fill this in

    Vehicle, VIN and title number

    The identifying block, matching the certificate exactly.

    Watch out: If you are completing this because the title is electronic and you have never seen it, take the VIN off the doorpost rather than off an old insurance document.

  2. 2
    You fill this in

    The reading, and miles or kilometres

    Whole units as the cluster shows them, then tick which unit it is. South Dakota's form does not ask you to convert.

    Watch out: Read it the day you sign, not the week before. A reading taken at the advert and disclosed at the sale is a discrepancy waiting to be noticed.

  3. 3
    You fill this in

    One of the three statements

    Actual mileage; exceeds the odometer's mechanical limits; or is not actual, which the form labels as a warning of an odometer discrepancy.

    Watch out: Exceeds mechanical limits means a cluster that rolled over, not one that is broken. A cluster that has been replaced is not actual, and that brand follows the car.

  4. 4
    You fill this in

    Your name, address and the date of sale

    The seller block under the certification that you certify by your signature to the truth and accuracy of this disclosure statement.

    Watch out: The certification is made under penalty of South Dakota law, and the statute above it makes a false entry a Class 6 felony. This is not a box to fill in optimistically.

  5. 5
    The buyer fills this in

    The buyer's block and second signature

    Name, address and signature, with the same date of sale. The buyer is acknowledging the reading you disclosed.

    Watch out: Get it signed while they are in front of you. Chasing a buyer for an acknowledgement after the car has gone is how a disclosure ends up unusable.

At a glance

What goes where

On the formWhat to put in it
Year, Make, ModelThe vehicle block at the head of the form.
VIN, Title NumberThe identification number and the South Dakota title number, so the sheet can be attached to the right record.
The odometer reading is ___, Miles or KilometersThe reading in whole units, and a tick for which unit the cluster shows. Kilometres are disclosed as kilometres here, not converted.
The stated mileage is: Actual mileageThe default. Tick it when the reading is what the vehicle has genuinely travelled.
Exceeds odometer's mechanical limitsFor a five-digit cluster that has rolled past its maximum. The reading is still written in - the tick says what it means.
Is not actual - WARNING: Odometer DiscrepancyFor a replaced, broken or tampered odometer. The form prints the word WARNING in the checkbox label, because that phrase is carried onto the buyer's next title.
Seller Name, Address, City, State, Zip CodeUnder the certification: I, as the seller, under penalty of South Dakota law, certify by my signature to the truth and accuracy of this disclosure statement.
Seller Signature, Date of SaleYour signature and the sale date. No notary and no witness.
Purchaser Name, Address, City, State, Zip Code, Signature, Date of SaleThe buyer's half. The disclosure is a two-signature document - an acknowledgement, not a declaration you make alone.

What gets this one rejected

Rules that decide whether it is accepted

Every line here was read off Form 1021 (no revision printed) itself — the PDF is here — and off the South Dakota Department of Revenue, Motor Vehicle Division pages. This is plain-language help with a form, not legal advice, and where our wording and the agency's differ, theirs governs.

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