Free GT-500003 - Florida

Suggested Format for Affidavit for Exemption of Boat Sold for Removal from the State of Florida by a Nonresident Purchaser

GT-500003 R. 12/01

The following is a suggested format for an affidavit to be completed by the purchaser and furnished to the selling dealer. In order to satisfy the requirements for exemption, the affidavit must contain all of this information and be completed in full.

STATE OF _______________ COUNTY OF_______________________

*** READ CAREFULLY BEFORE SIGNING ***
Before me this day personally appeared the below named affiant who, being duly sworn, deposes and says:
1. 2. 3. 4. 5. I have read the Florida Department of Revenue Rule 12A-1.007(9), Florida Administrative Code, and § 212.05, Florida Statutes (F.S.); and I am not a resident of the State of Florida and did not make my permanent place of abode in Florida at the time of taking delivery of the boat designated below; and I am not engaged in Florida in any employment, trade, business, or profession for which the designated boat will be used in Florida; and I represent a corporation which has no officer or director who is a resident of, or makes his or her permanent place of abode in Florida; and I represent an artificial entity other than a corporation which has no individual vested with authority to participate in the management, direction, or control of the affairs of the entity who is a resident of Florida, or makes his or her permanent place of abode in Florida; and Within 30 days of the date of departure from Florida of the herein described boat, I agree to furnish the Florida Department of Revenue with written proof that this vessel was licensed, titled, registered or documented outside Florida; and Within 10 days of the date of departure of the herein described vessel, I agree to furnish the Florida Department of Revenue with invoices for fuel, dockage charges, or repairs issued by out-of-state vendors or suppliers or other documentary evidence which specifically identifies this boat, including the hull ID number; and I claim exemption under § 212.05(1)(a)2., F.S., from Florida sales and use tax on the purchase of the boat designated below for the following reason: Boat herein identified and described is 5 net tons of admeasurement or larger and I plan to have the boat in Florida for a period up to 90 days from the date of purchase. I hereby agree to purchase from the selling dealer, at the time of sale, a decal issued by the Florida Department of Revenue authorizing the boat to remain in Florida up to 90 days following the date of sale. I further agree to remove the boat from Florida within the 90 day period authorized by the decal and understand that the 90 day period may not be tolled for any reason including repairs. Boat will be removed by me or by my designated agent from the State of Florida within 10 days of the date of purchase. Boat is to be repaired or altered and will be removed from the State of Florida by me or by my designated agent within 20 days (excluding tolled days) after completion of the repairs or alterations consistent with § 212.05, F.S.

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PLEASE TYPE OR PRINT THE FOLLOWING INFORMATION: Name of Purchaser __________________________________________________________ SSN: ________________ If Purchaser is a Corporation or Partnership, List Officers or Partners _________________________________________ _________________________________________________________________________ T.I.N. ________________ Purchaser's Permanent Address (Street) _______________________________________________________________ (City) ________________________________________ (State/Country) ________________ (ZIP) ________________ Purchaser's Daytime Telephone Number ( _ ) _________________ D.O.B. ____________________________________ Purchaser's Driver's License Number and State of Issuance ________________________________________________ Purchaser's Passport or Visa Number _________________________________________________________________ Name of Selling Dealer _____________________________________________________________________________ Address of Selling Dealer (Street) _____________________________________________________________________ (City) ________________________________________ (State/Country) ________________ (ZIP) ________________ Selling Dealer's Florida Sales and Use Tax Registration Number ____________________________________________ Dealer's Telephone Number ( __ ) __________________ Date of Sale (Month) ____________ (Day) ________ (Year) ______________

DESCRIPTION OF BOAT Make ______________________ Model ___________________ Year _______________________ Hull Number ______________________________________ New Used Name of Vessel (New) _______________________________ (Ex) _________________________________________ State/County Registration and/or Coast Guard Documentation Number _______________________________________ Sales Price __________________________________ Trade-In Allowance ____________________________________ Net Amount Paid __________________________________ Ninety Day Decal Number, if applicable (Affix Here): ______________________________________________________ Primary Location of the Vessel Prior to Removal: _________________________________________________________ _______________________________________________________________________________________________

Under the penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true to the best of my knowledge and belief. I understand that if I fail to comply with the requirements of this affidavit I will be liable for payment of the tax and a mandatory penalty equal to the tax. I further understand that if I purchase a decal and remove or alter it, or cause or allow another person to do the same, then I will be subject to payment of the tax plus a 200 percent penalty. I further understand that I may be subject to imprisonment of up to 1 year and a fine of up to $1000.00.
____________________________ Signature of Affiant (Purchaser)

Sworn to (or affirmed) and subscribed before me this day of ____________ , ________ .

Signature of Notary

Print, Type or Stamp Name of Notary Personally known Produced identification Type of Identification: ___________________________

Original and copy of invoice, bill of sale or closing statement must be submitted within five (5) days of the date of sale to the Florida Department of Revenue, Central Compliance and Enforcement, Boat Enforcement Unit, P.O. Box 6417, Tallahassee, Florida 32314-6417. 1st copy: To be retained by the dealer and made part of the dealer's records 2nd copy: Purchaser's copy Dealer's Notice: Affidavits not filed within five (5) days of the date of sale or closing will not be accepted by the Florida Department of Revenue.