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					                              Kaohsiung County Revenue Service Office
                           Refund Application Form for Vehicle License Tax
                                                          Application Date: ___/___/___ (mm/dd/yy)
 Type of Vehicle                   Reason                Tag No.          -
    Motorcycle                Redundant Payment         Period of     ___ period in the Year of ____
   Small Private           Overpayment of Tag Tax
   Passenger car           due to following reasons:                   Attachments
   (cargo truck)
  Small Business           Above-mention vehicle, on             ____ copy (copies) of Vehicle License Tax
   Passenger car           ___ / ___ /___ (mm / dd /             payment receipt(s)
   (cargo truck)           yy) , was paid for its tax,
   Large Private           cancelled for its vehicle
   Passenger car           license, stolen, scrapped,            ____ copy (copies) of Vehicle License Tax
   (cargo truck)           suspended to drive,                   payment receipt(s) photo copy
                           exempted from tax,
   Large Business          stripped of tag, cancelled of  One copy of being paid for its tax, cancelled
    Passenger car          vehicle registration,          for its Vehicle License, stolen, scrapped,
    (cargo truck)          forbidden by law, changed      suspended to drive, exempted from tax,
                           in its shape, or               stripped of tag, cancelled of vehicle
                           miscalculated for the tax      registration, forbidden by law, or changed in
                           amount.                        its shape
                                                          (Those that having updated registration in
                                                          City Motor Vehicle Office need not attach
                                                          the copy.)
Portion of overpayment or redundant payment of Vehicle License Tax is demanded to refund.

                                           Applicant (Vehicle Owner):                            Stamp
                                           Identity Card Number:
                                           Telephone Number:

Receipt lost, should there and fraud to apply              I hereby certify that the Vehicle License Tax for the vehicle No.
for the Vehicle License Tax overpayment                    ___-__________ for the period of ____ in the year of _____
refund, I shall bear the legal responsibility              was duly paid by me.
                                                           Certifier: __________________________
Signature/Stamp: (                   )

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