Clear form Utah State Tax Commission 210 N 1950 W • Salt Lake City, UT 84134 • www.tax.utah.gov TC-719 Sales and Use Tax Exemption Affidavit Rev. 5/07 for Authorized Interstate Carriers Purchaser or Lessee Information Purchaser/Lessee name Purchase/Lease date Purchaser/Lessee address Telephone number The purchaser/lessee or operator certifies the following: For Purchaser/Lessee of Vehicles The purchased/leased vehicle is a qualified vehicle under IFTA and IRP requirements (over 26,000 pounds or three axles), and will be operated pursuant to the International Registration Plan (IRP) and the International Fuel Tax Agreement (IFTA). Qualified vehicles do not include recreational or passenger vehicles. Purchaser/Lessee’s Purchaser/Lessee’s IRP account number: ___________________ AND _ _ _ _ _ _ _ _ __ IFTA account number: _ _ _ _ _ _ _ _ _ For Purchaser/Lessee of Aircraft Purchaser/Lessee is the holder of a certificate issued by the Federal Aviation Administration (FAA) authorizing the holder to engage in interstate commerce. _ _ _ _ _ _ _ _ _ FAA operating certificate / air carrier operating certificate number: _ _ _ _ _ _ _ _ _ _ For Purchaser/Lessee of Locomotive, Freight Cars, Railroad Equipment, and Other Rolling Stock Purchaser/Lessee is the holder of a certificate issued by the United States Department of Transportation Surface Transportation Board authorizing the holder to engage in interstate commerce. _ _ _ _ _ _ _ _ _ Surface Transportation Board certificate number: _ _ _ _ _ _ _ _ _ _ Under penalties of perjury, the information contained in this affidavit is true, correct and complete. X _ _ _ _ _ _ _ ____________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Purchaser/Lessee’s (or authorized agent’s) signature Date Seller/Lessor Information Seller/Lessor’s name Dealer number (sales tax acct. #, if lessor) Seller/Lessor’s address Vehicle/Aircraft/Equipment Information If you are purchasing more than space allows below, attach a separate listing. Vehicle/Aircraft/Equipment Identification # Year Make Model ORIGINAL to the Utah State Tax Commission at the point of registration. If unit is sold by a Utah bonded motor vehicle dealer, attach copy to the Dealer Report of Sale. Seller/Dealer/Purchaser: Make copies for your records. If you have questions, call (801) 297-7705 or toll free 1-800-662-4335 ext. 7705. If you need an accommodation under the Americans with Disabilities Act, contact the Tax Commission at (801) 297-3811 or (TDD) Telecommunications Device for the Deaf (801) 297-2020. Please allow three working days for a response.
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