Form Lv2 - Certificate Of Exemption Leased Vehicle Excise Tax - City Of Columbus, Ohio

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MELINDA J. FRANK
Income Tax Division Administrator
50 W. Gay St.
MICHAEL D. JONES
4th Floor
Assistant Income Tax Division Administrator
Columbus, Ohio 43215
DAVID J. CHRISMAN
Assistant Income Tax Division Administrator
CITY OF COLUMBUS
OHIO
INCOME TAX DIVISION
CERTIFICATE OF EXEMPTION
LEASED VEHICLE EXCISE TAX
Name Lessor
Date
Business Address
Lease period / No. of days
This is to certify that the undersigned hereby claims exemption from the leased vehicle excise tax,
imposed by CHAPTER 373, COLUMBUS CITY CODES, 1959, payable by said Lessor.
Lessor must state statutory reason for exemption:
Statutory Reason for Exemption:
Lessee’s Name
Lessee’s Address
Title (Lessor’s Employee)
Prepared by (Lessor’s Employee)
Lessor’s Federal ID No.
Date
Substantiating documentation of exemption basis must be retained in lessor’s records. C.C.C. §373.04
LV2 (Rev. 07/02)

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