Rev 31 1487 - Retail Sales Tax Exemption Certificate For Vehicles Sold To Enrolled Tribal Members
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Retail Sales Tax Exemption Certificate for Vehicles Sold
State of Washington
Department of Revenue
to Enrolled Tribal Members by Auto Dealers
PO Box 47450
Olympia WA 98504-7450
Do Not Return This to the Department of Revenue
Retail Sales Tax Exemption
There is a sales tax exemption provided when a motor vehicle, trailer, snowmobile, off-road vehicle, or other such property is sold to
an enrolled Tribal member and delivery is made on the enrolled Tribal member’s reservation/trust land (Indian country) in the state of
Washington. To sustain this exemption, this form must be completed. However, additional substantiation/documentation may be
required beyond this form to document actual delivery in Indian country as is required to sustain any exemption based on delivery
point (e.g., interstate and foreign sales). Such additional documentation could be in the form of copies of gas receipts (from a gas
station at or near the delivery point in Indian country), trip tickets, a photograph of the delivered vehicle at a landmark location in
Indian country, etc.
B&O Tax
Sales of motor vehicles, trailers, snowmobiles, off-road vehicles, and other tangible personal property by non-Indians to enrolled tribal
members in their Indian country are subject to the business and occupation tax under “retailing” unless one of the exemptions listed in
WAC 458-20-192(7) applies.
Declaration of Buyer
Declaration of delivery or acquisition in Indian Country
The undersigned is:
An enrolled member of the
Tribe
An authorized representative of the Tribe or Tribal enterprise, and the vehicle described below was delivered/acquired
within Indian country, for at least partial use in Indian country
Buyer’s name:
Buyer’s signature:
Buyer’s address:
Address of delivery:
Check documentation presented:
Certificate of enrollment
Treaty Indian Fishing Identification Card
Tribal membership card
Official letter signed by Tribal official
Certification of Seller
Seller’s name:
Address of seller:
I certify that the ,
(Year, Make, and Model of Vehicle)
(Vehicle Identification No.)
was delivered to the buyer on the Washington reservation/trust land of the
Tribe,
of which the buyer documented Tribal membership. This certificate is given with full knowledge of, and subject to, the legally
prescribed penalties for fraud and tax evasion.
Signature of seller
Date:
or Agent of seller:
For tax assistance or to request this document in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the
Washington Relay Service by calling 711.
REV 31 1487 (8/28/12)
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