Gt-500002 5/2 - Suggested Format For Affidavit For Exemption Of Aircraft Sold For Removal From The State Of Florida By A Nonresident Purchaser Form
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2GT-500002
Suggested Format for Affidavit for Exemption of Aircraft Sold for
N. 05/02
Removal from the State of Florida by a Nonresident Purchaser
The following is a suggested format of 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 appeared the affiant named below, who being duly sworn, states that:
1.
I have read Rule 12A-1.007(10), Florida Administrative Code, and § 212.05, Florida Statutes; and
2. 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 aircraft described below; and
3. I am not engaged in Florida in any employment, trade, business, or profession for which the described aircraft
will be used in Florida; and
4. I do not represent a corporation which has any officer or director who is a resident of Florida, or makes his
or her permanent place of abode in Florida; and
5. I do not represent an artificial entity other than a corporation which has any 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
6. I agree to furnish the Florida Department of Revenue (within 30 days of the date of departure) written proof
that this aircraft was licensed, titled, or registered outside Florida; and
7. I agree to furnish the Florida Department of Revenue (within 10 days of the date of departure) invoices for
fuel, tie-down or hangar charges, repairs, or other similar documentation issued by an out-of-state vendor or
supplier which identifies this aircraft and its timely removal (including the FAA registration number).
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 or broker ______________________________________________________________________
Address of selling dealer (Street) _____________________________________________________________________
(City) ________________________________________ (State/Country) ________________ (ZIP) ________________
Selling dealer or broker’s Florida certificate of registration number ___________________________________________
Selling dealer or broker’s telephone number ( _____ ) ____________________
Date of sale (Month) _____________ (Day) ________ (Year) _______________
(continued on reverse side)
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