Private Vehicle Sale Secure Payment Agreement Form
Use this form to record the vehicle, sale price, secure payment arrangement, handover details, and both parties’ agreement for a private vehicle sale.
Vehicle and Sale Details
Vehicle Make
*
Vehicle Model
*
Vehicle Year
*
Vehicle Color
Mileage
*
Vehicle Identification Reference
Sale Price
*
Currency
*
Please Select
USD
EUR
GBP
CAD
AUD
Other
Sale Date
*
-
Month
-
Day
Year
Date
Included Accessories / Items
Sale Condition
*
As-is
Subject to agreed condition(s)
Buyer and Seller Contact Information
Seller full name
*
First Name
Middle Name
Last Name
Buyer full name
*
First Name
Middle Name
Last Name
Seller phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Buyer phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Seller email
*
example@example.com
Buyer email
*
example@example.com
Preferred contact method
*
Phone
Email
Secure Payment Arrangement
Payment Method
*
Cash
Bank Transfer
Certified Check
Escrow Service
Other
Deposit Amount
Remaining Balance Amount
Payment Due Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Is Payment Complete Before Vehicle Handover?
*
Yes
No
Buyer Acknowledges Agreed Secure Payment Process and Release Conditions
*
Yes
No
Pickup, Handover, and Condition Confirmation
Pickup location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Pickup date and time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Who will deliver the vehicle?
*
Seller
Buyer
Third party
Other
Odometer reading at handover
*
Condition notes at transfer
Items and documents transferred
*
Vehicle keys
Spare key
Registration papers
Service records
Owner's manual
Maintenance receipts
Other
Did both parties inspect and accept the vehicle condition before transfer?
*
Yes
No
Declarations and Agreement Confirmation
Agreement Acknowledgment
*
Both parties agree to the sale price, payment arrangement, handover conditions, and that the vehicle will not be released until the agreed payment requirement is satisfied
I do not agree
Seller Signature
*
Seller Signature Date
*
-
Month
-
Day
Year
Date
Buyer Signature
*
Submit Agreement
Submit Agreement
Should be Empty: