1. Parties

Seller

Name: [Seller Full Name or Business Name]

Address: [Seller Street Address]

City, State/Province, ZIP/Postal Code, Country: [Seller City, State/Province, ZIP/Postal Code, Country]

Phone: [Seller Phone Number]

Email: [Seller Email Address]

Buyer

Name: [Buyer Full Name or Business Name]

Address: [Buyer Street Address]

City, State/Province, ZIP/Postal Code, Country: [Buyer City, State/Province, ZIP/Postal Code, Country]

Phone: [Buyer Phone Number]

Email: [Buyer Email Address]

2. Vehicle Details

• Vehicle Type: Car
• Make: [Vehicle Make]
• Model: [Vehicle Model]
• Year: [Vehicle Year]
• Color: [Vehicle Color]
• Body Style: Sedan
• Vehicle Identification Number (VIN): [VIN]
• License Plate Number (if applicable): [Plate Number]
• Odometer Reading at Time of Sale: [Odometer Reading and Unit] miles

3. Payment and Price

Total Purchase Price: [Currency and Amount in Numbers]

Total Purchase Price (in Words): [Amount in Words]

Payment Received on Date of Receipt: [Currency and Amount]

Payment Status (select one):

☑ Full payment received – no remaining balance.

☐ Partial payment received – remaining balance due.

4. Payment Method

Payment Method Used for This Receipt (select or complete):

Reference / Transaction Number (if applicable): [Transaction or Check Number]

5. Basic Transaction Description

This receipt confirms that the Seller has received the amount listed in Section 3 from the Buyer as payment for the vehicle described in Section 2.

Purpose of Payment (select one or describe):

6. Delivery and Possession

Vehicle Delivery Status (select one):

☑ Vehicle delivered to Buyer on [MM/DD/YYYY] at [Time]

☐ Vehicle will be delivered to Buyer on [MM/DD/YYYY] at [Time]

☐ Vehicle pickup arranged by Buyer on [MM/DD/YYYY] at [Time]

Location of Delivery or Pickup: [Address or Location Description]

7. Acknowledgments

Seller Acknowledgment

The Seller acknowledges receipt of the payment amount recorded in this Vehicle Receipt and confirms that the information provided in Sections 1–6 is accurate to the best of the Seller's knowledge.

Buyer Acknowledgment

The Buyer acknowledges that this Vehicle Receipt serves as proof of payment for the vehicle described in Section 2 and that the Buyer has received or will receive the vehicle as described, subject to any separate written agreement or bill of sale between the Parties.

9. Signatures