(C) Nothing in this section prevents the service of an odometer, provided that after the service a completed form, captioned "notice of odometer repair," shall be attached to the left door frame of the motor vehicle by the person performing the repairs. The notice shall contain, in bold-face type, the following information and statements:
"Notice of Odometer Repair
The odometer of this motor vehicle was repaired or replaced on _________________ (date of service).
The mileage registered on the odometer of this motor vehicle before repair was ___________ (mileage).
The mileage registered on the odometer of this motor vehicle after repair is ___________ (mileage).
_______________________
(Repairer's signature)"