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BASED OUT OF STATE
CERTIFICATE OF EXEMPTION FOR AIRCRAFT
Form AE-1
Issued 12-94
SF 46815
Name of Aircraft Owner
Address
City
Zip Code
State
WY
I hereby certify under the penalty of perjury that the aircraft described below is exempt from INDIANA AIRCRAFT
REGISTRATION AND TAX because the aircraft will be based immediately in the State of ______________________
to be licensed or registered for use in that State, and will not at any time be based in the State of Indiana, as provided for
in I.C. 6-6-6-.5-9(a)(6). I hereby authorize the Indiana Department of Revenue to forward a copy of this affidavit to the
Revenue Department of such State.
Aircraft Owner’s Signature
Date
Aircraft Owner’s Printed Name
BASE LOCATION OF AIRCRAFT
DOCUMENTS REQUIRED (attach one from each section)
Section A
Hangar Lease Agreement
Hangar Rent Receipts (Minimum 11 months)
Letter from Airport Manager
Section B
Paid Sales Tax Receipt
Current State Registration
AIRCRAFT DESCRIPTION
FAA N NUMBER
Aircraft year of Mfg.
Serial Number
Aircraft Make
Aircraft Model
Aircraft Purchase Date
INSTRUCTIONS: Based Out of State Certificate of Exemption must be completed and returned with required documents to:
Indiana Department of Revenue, Compliance Division - Aeronautics, P.O. Box 644, Indianapolis, IN 46206-0644 within
thirty (30) days after the purchase date. Each calendar year thereafter, Based Out of State Certificate of Exemption must be filed on
or before the last day of February.
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