TC-719, Utah Sales Tax Exemption Affidavit for by ber12069

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									                                                                                                                    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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