Utah State Tax Commission
Sales Tax Exemption Affidavit for Authorized Interstate Carriers
TC-719 Rev. 4/03
Clear form
Purchaser or Lessee Information
Purchaser/Lessee name
If you have questions, call (801) 297-2200 or toll free 1-800-662-4335. 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.
Purchase/Lease date Telephone number
Purchaser/Lessee address
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 IRP account number _________________________________
AND
Purchaser/Lessee's 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.
Purchaser/Lessee's (or authorized agent) signature X Date signed
Seller/Lessor Information
Seller/Lessor's name Seller/Lessor's address Dealer number (sales tax account no. if lessor)
Vehicle/Aircraft/Equipment Information If you are purchasing more than space allows below, attach a separate listing.
Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Vehicle/Aircraft/Equipment identification or registration number Year Year Year Year Year Year Year Year Year Make Make Make Make Make Make Make Make Make Model Model Model Model Model Model Model Model 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.