Form 50-285 - Lessee'S Affidavit Of Primarily Non Income Producing Vehicle Use - 2001
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1Comptroller
50-285
T
E
of Public
S
X
Accounts
(8/01)
A
FORM
LESSEE’S AFFIDAVIT OF PRIMARILY NON INCOME PRODUCING
YEAR
VEHICLE USE
Appraisal district name
For the owner of a vehicle leased for personal use, this affidavit must be completed by the person leasing the vehicle. This document
must then be retained by the owner of the leased vehicle and made available to the appraisal district, on request, for copying or inspec-
tion.
Your lease agreement or title should provide you with the information about your leased automobile required by
Step 1:
boxes 1 through 10.
Provide
1. Vehicle Identification Number
2. Year
data about
the leased
3. Make
4. Body style
5. Model
6. Empty weight*
7. Lease date
vehicle.
8. Owner name and address
9. Lessee name
10. Driver’s License number or Personal Identification number
If you do not have a street address, please provide your mailing address.
Step 2:
Provide
11. Lessee street or mailing address 12. City
13. State
14. ZIP code
15. County name
information
about your
home address.
Step 3:
If the vehicle is usually located at an address other than the home address you provided in Step 2, or if the address
Provide
provided in Step 2 is a post office box or rural route, provide the physical address at which the vehicle is primarily
information
located.
if your vehicle
is not at home
16. Vehicle street address
17. City
18. State
19. Zip code
20. County name
address.
Step 4:
Notarization by the person leasing the vehicle.
Notary
I swear and affirm that I: (have not held and will not hold) - or - (will not hold**) the vehicle for the production of the
income. The above described leased vehicle (has been -or- will be**) used primarily for activities that do not pro-
duce income.*** I affirm that each item stated above is true and correct and I understand that if at any time this
affidavit becomes inaccurate, I must notify the person from whom I leased the vehicle.
Lessee signature
I attest that the individual signing above subscribed and swore to the accuracy and truth of the information provided on this
form before me, this the _________ day of __________________________ , ___________ .
Notary Public
*
If the empty weight of the leased vehicle exceeds 9,000 pounds, the vehicle does not qualify for this exemption.
** The first phrase should be used by those who leased the vehicle on or after January 2, 2001, but before this form was prescribed. The last phrase
should be used by those leasing a vehicle after the form was prescribed.
*** Section 11.252, Tax Code, provides that a vehicle is used primarily for non-income producing activities when 50 percent or more of the total mileage
for a 12-month period was for non-income producing purposes.
If you make a false statement on this form, you could be found guilty of a class A misdemeanor or state jail felony under
Texas Penal Code Section 37.10.
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