SELLER'S
DAMAGE DISCLOSURE STATEMENT
Wyoming state law W.S. 31-2-104 (e) requires you to
disclose damage upon transfer of ownership of a motor
vehicle. Failure to complete or providing a false statement
may result in a fine of not more than $750.00 and/or
imprisonment of up to six months.
I.
I,
________________________________________
(Name
of person making disclosure - please print)
Hereby
state that the vehicle:
has
has NOT sustained damage in excess of $4,000.00
in any single occurrence.
The cause of the disclosed damage was:
Collision
Fire
Vandalism
Submersion
in Water
Weather
II.
I,
________________________________________ (Name
of person making disclosure - please print)
Hereby state that I have no knowledge of any
undisclosed damage in excess of $4,000.00 from
any single occurence which may have occured
prior to the time I came into possession of
the vehicle.
I, ______________________________________ (Name of Buyer)
Hereby
waive my right to a DAMAGE DISCLOSURE STATEMENT
and accept this vehicle regardless of whether
or not this vehicle has
sustained prior or undisclosed damage.
