State of Florida Department of Highway Safety and Motor Vehicles (FLHSMV) Form HSMV 82993, Separate Odometer Disclosure Statement and Acknowledgment Instructions

Enter the buyer’s full printed name as it should appear on the title (first and last name, include middle initial if applicable).

Enter the buyer’s street address for the mailing/residence location, including apartment or unit number if applicable.

Enter the city for the buyer’s street address.

Enter the buyer’s state of residence (use the two‑letter USPS abbreviation or full state name).

Enter the buyer’s postal ZIP code for the street address (5‑digit ZIP or ZIP+4 if available).

Enter the numeric month when the odometer was read (e.g., 01 for January, 12 for December).

Enter the numeric day of the month when the odometer was read (e.g., 01–31).

Enter the four-digit year when the odometer was read (e.g., 2026).

Check this box if the vehicle's odometer is a 5-digit instrument (indicating the mileage reading to be entered is from a 5-digit odometer).

Check this box if the vehicle's odometer is a 6-digit instrument (indicating the mileage reading to be entered is from a 6-digit odometer).

Enter the vehicle's current odometer reading in miles as shown on the odometer.

Check this box when the odometer reading shown is the true and correct mileage of the vehicle at the time of transfer.

Check this box when the odometer has rolled over or exceeded its mechanical limit and the displayed reading does not represent the full mileage (applies to odometers with mechanical limits).

Check this box when the odometer reading is known to be incorrect or does not reflect the vehicle's actual mileage (indicating an odometer discrepancy).

Enter the seller's full printed name exactly as it should appear on the title or legal documents.

Enter the seller's street address including house number, street name and any apartment or unit number.

Enter the city of the seller's mailing or residence address.

Enter the seller's state (use the two-letter U.S. postal abbreviation or the full state name).

Enter the postal ZIP code for the seller's address.

Enter the vehicle identification number exactly as shown on the title or registration, including all letters and digits with no spaces omitted.

Enter the vehicle's model year as shown on the title or registration.

Enter the vehicle manufacturer or brand name (for example, Ford, Toyota, Honda) as shown on the title or registration.

Enter the primary exterior color of the vehicle as listed on the title or registration.

Enter the vehicle body style (for example, sedan, coupe, pickup, SUV) as shown on the title or registration.

Enter the vehicle title number exactly as it appears on the title certificate or registration.