Seller'S Report Of Sale - Illinois Secretary Of State

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Seller’s Report of Sale
Secretary of State.
Secretary of State
Vehicle Services epartment
Record Inquiry Section
501 S. Second St., Rm. 408
Springfield, IL 62756
When you sell and/or release interest in a vehicle that is titled and/or registered in the State of Illinois, this form must be immediately
completed and mailed to the Secretary of State Vehicle Services Department to ensure that your responsibility for the vehicle is released.
Completion of this form does not satisfy the transfer of ownership requirements set forth in the Illinois Compiled Statutes. Illinois law
requires the owner of a vehicle to complete and sign the Assignment of Title section on the Certificate of Title to the buyer who must
then apply to the Vehicle Services Department.
Date of Sale __________________________________________________________________________________________________
Vehicle Year______________________Vehicle Make____________________________________________________________________
Vehicle Identification Number (VIN) ________________________________________________________________________________
Name of Seller
______________________________________________________________________________________________
Address of Seller ________________________________________________________________________________________________
________________________________________________________________________________________________
City
State
ZIP
Name of Buyer
________________________________________________________________________________________________
Address of Buyer ________________________________________________________________________________________________
________________________________________________________________________________________________
City
State
ZIP
Mail To:
Secretary of State
Vehicle Services Department
Record Inquiry Division
501 S. Second St., Rm. 408
Springfield, IL 62756
Under penalties of perjury, I hereby certify that the foregoing is true and correct under the laws of the United States of America.
Executed on __________________________
______________________________________________________________________
Date
Signature of Seller
____________________________________
______________________________________________________________________
Printed Name of Seller
Printed by authority of the State of Illinois. May 2013 — 1 — VSD 703.1

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