Request For Motor Vehicle Sales/use Tax Refund - Wyoming Department Of Revenue

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Wyoming Department of Revenue
Excise Tax Division
122 W. 25
th
Street, Herschler Bldg.
Cheyenne, Wyoming 82002-0110
(Please Print or Type the following information)
Name: Individual or Business
Principal residence address
Contact Phone Number(s)
Fax Number(s)
I am requesting a refund of Wyoming Motor Vehicle Sales/Use Tax paid to ________________
County Treasurer’s office on __________________.
In the amount of $_______________________for the following reason(s):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Supporting Documentation Required for Motor Vehicle Sales/Use Tax Refunds:
1. A copy of all purchase invoices or bill of sale issued by the seller or dealer.
2. A copy of all receipts issued for the payment of sales/use tax.
3. A copy of “Proof of Residency” at the time of purchase, if applicable.
4. A copy of your tribal enrollment of one of the two tribes residing on the Wind River
Indian Reservation, and your reservation address, if applicable.
5. A copy of the Title.
6. A copy of the lease agreement, if applicable.
7. A copy of Motor Vehicle Vendor Form “Wyoming Sales/Use Tax Statement” provided
to you by the dealer.
______________________________________________________ _____________________
Signature of Claimant
Date
Revised Mvrefund 106, 9/08/03

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