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Utah State Tax Commission
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TC-928 Rev. 11/04
Year
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Monthly Report of Sale
By Utah Licensed and Bonded Dealer
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?
Reporting dealership
Month
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Dealer number
Total count of sales
? Year ? Make ? Model
Consignor (if any)
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Vehicle Identification Number
? Odometer ? Buyer's name
? Date of Sale ? Buyer's address
? Buyer's dealer #
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Year Make Model Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
Year
Make
Model
Vehicle Identification Number
Odometer Date of Sale
Buyer's name Buyer's address
Buyer's dealer #
Consignor (if any)
During the month of ____________________________, 20 _____, I sold and delivered the vehicles above to the buyers noted above. I further state that this is page number _______ of _______ total pages in this report, and that these pages contain a record of all wholesale sales, retail sales where no temporary permit was issued, and non-resident sales made by this dealership during the month noted above. Signature of seller or authorized agent
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Title
Date of report
Return this form to: Utah State Tax Commission, Motor Vehicle Enforcement Division, 210 North 1950 West, Salt Lake City, Utah 84134.
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