Odometer Disclosure Statement - Leased Vehicles - Complete and Submit Form

Sep 22, 2026

Instructions and certification form for leased vehicle odometer disclosure to JPMorgan Chase Bank, N.A. The document explains how to fill the statement accurately, including entering current mileage without tenths, providing vehicle year/make/model and VIN, selecting the correct body type, and ensuring the lessee’s signature matches printed names. It states federal (and possible state) law requirements, warns that false or incomplete statements may lead to fines and/or imprisonment, and provides submission options by email, fax, or mail.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Instructions for Completing the Odometer Disclosure Statement

Required accuracy and filling rules

Correction process and non-editing requirements

Odometer Disclosure Statement (Leased Vehicles)

Legal requirement and certification options

Vehicle and lessee information

Submission, signatures, and dates

Instructions for Completing the Odometer Disclosure Statement • The form must be filled out completely and accurately. • Do not alter this form-no corrections or cross-outs. Do not use white-out. • Do not print double-sided. • If you need to make a correction, please download a new form at: [https://www.chase.com/personal/auto-loans/forms-center](https://www.chase.com/personal/auto-loans/forms-center) • See arrows below for important details. Enter current mileage of the vehicle. Do not include tenths of a mile (For example: 47000.2 should be entered as 47000) Accurately enter vehicle Year, Make, Model and VIN details. Check appropriate Body Type box. Lessee’s signature must match names printed above. . The directions contained herein are intended to help reduce clerical errors and do not constitute legal advice from JPMorgan Chase Bank, N.A. If you have a question regarding how to complete the form you should consult with your own legal counsel. (24-029-A) 3/24 Please complete, sign, and submit the form via email at [title.management@chase.com](title.management@chase.com). Or Fax: 1-877-501-7620 Or mail: Chase Auto, 700 Kansas Lane, Mail-Code LA4-4042, Monroe, LA 71203. ODOMETER DISCLOSURE STATEMENT (LEASED VEHICLES) When returning or purchasing your leased vehicle, please complete, sign and return disclosure form below to JPMorgan Chase Bank, N.A. FEDERAL LAW (AND STATE LAW, IF APPLICABLE) REQUIRES THAT THE LESSEE DISCLOSE THE MILEAGE TO THE LESSOR IN CONNECTION WITH THE TRANSFER OF OWNERSHIP. FAILURE TO COMPLETE OR MAKING A FALSE STATEMENT MAY RESULT IN FINES AND/OR IMPRISONMENT. I (print name of person making disclosure) , hereby certify that the odometer now reads (no tenths) miles. Please check only one box. 1. I hereby certify that, to the best of my knowledge, the above-listed odometer reading reflects the actual mileage of the vehicle described below. 2. I hereby certify that, to the best of my knowledge, the above-listed odometer reading reﬂects the amount of mileage in excess of its mechanical limits. 3. I hereby certify that the above-listed odometer reading is not the actual mileage. Warning-Odometer Discrepancy. Year Make Model Vehicle Identiﬁcation Number (VIN) Body Type (select one): Convertible Coupe Sedan SUV Truck Other Lessee: Please complete this form and return it with the payoff check for title release. Note if any part of the odometer statement is illegible, unsigned, undated or incomplete the title will not be released. Lessee’s Name and Address Information: Lessee Name: Lessee Address: CITY STATE ZIP Lessee’s Signature: Date of Statement: DO NOT WRITE BELOW THIS LINE Lessor's Name: JPMorgan Chase Bank, N.A. Lessor's Address: Chase Auto, 700 Kansas Lane, Mail Code LA4-4042 , Monroe, LA 71203 Date Disclosure Form sent to Lessee: Date Completed Disclosure Form Received from Lessee: Lessor’s Signature: Name and Title: Version 7. B (24-029-C) 3/24

FAQs

What information must be entered when completing the leased vehicle odometer disclosure statement?

You must enter the current mileage (without tenths) and accurately provide the vehicle year, make, model, VIN, and select the appropriate body type. You also must provide the lessee’s name and address information and include a valid date of statement.

How should corrections be handled if there is an error on the form?

Do not alter the form and do not make corrections with cross-outs or white-out. Download a new form from the forms center and complete it again.

Which certification option should the lessee select and why does it matter?

Select only one box based on the truthful statement about the odometer reading. The document warns that false statements or failure to complete the form may result in fines and/or imprisonment.

Sep 22, 2026

Upload by Guten tag