Seller’s declaration free of charges

To be filled in and signed by the current owner of the vehicle, at the time of the sale.

1THE CURRENT OWNER (SELLER)

Full name, or company

Company no. (if a company)

Full address

Phone

2THE VEHICLE

Make

Model

Plate

Chassis number (VIN), 17 characters

NUR (if it has one)

3THE DECLARATION

I, the undersigned, current owner of the vehicle described above, declare that I am selling it today and certify on my honour that it is free of any credit, pledge, lease, retention of title and seizure.

I certify that this declaration is accurate.

Reminder: the seller protects the buyer against any third-party right over the vehicle that was not declared at the time of the sale (article 1626 of the former Belgian Civil Code, taken over by Book 7 of the Civil Code). A false declaration makes its author liable. Before you pay: check the National Pledge Register (FPS Finance) and have the vehicle checked by NUR Label.

4THE BUYER (OPTIONAL)

Buyer’s full name

5DATE AND SIGNATURE

Signed at

On (date)

Signature of the current owner

Sign here with your finger or mouse

Handwritten signature on the printed document, or a finger signature on screen on nurlabel.be (simple electronic signature: the date, the time and the document’s fingerprint are recorded on it). Template made available free of charge by NUR Label, which is not a party to the sale. It is complemented by consulting the National Pledge Register and, for any legal question, by a lawyer’s advice.

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