Form St-137rv - Affidavit Of Exemption By A Nonresident On The Purchase Of A Recreational Vehicle/cargo Trailer

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Indiana Department of Revenue
ST-137RV
State Form 52705
(R2 / 5-08)
Affidavit of Exemption by a Nonresident
on the Purchase of a Recreational Vehicle/Cargo Trailer
Purchaser’s Information
Name of Purchaser
Social Security or Federal Identification Number (mandatory)
Address
City
State
Zip Code
Purchaser’s Affidavit
I understand that a person who issues an exemption certificate, with the intention of unlawfully avoiding the payment of
the state gross retail or use tax, commits a Class B misdemeanor, per I.C. 6-2.5-9-1.
I hereby certify under penalty of perjury:
•
Purchaser is not a resident of the State of Indiana.
•
Purchaser is a legal resident of the State of ____________________ .
•
The Recreational Vehicle or Cargo Trailer described below will be removed from the State of Indiana within 30 days to
be registered/titled in the state of _______________ .
__________________________________________________________________
_______________________
Purchaser/Agent’s Signature (indicate if an agent for the buyer – see instructions)
Date
Primary Operator’s Driver License Number:_______________________________
State of: ________________
Description of Purchase
Year
Make
q New
q Used
q Recreational Vehicle
Model
VIN
q Cargo Trailer*
*Kentucky, Maine and Rhode
Island residents must pay Indiana
Total Selling Price
Trade Allowance Value
Sales Tax on Cargo Trailers.
Seller’s Information
Tax must be collected if purchaser is a
Name of Licensed Dealer/Seller
resident of a state/country listed below.
Address
Arizona
Mississippi
City
California
North Carolina
Florida
South Carolina
Hawaii
Canada
State
Zip Code:
Massachusetts
Mexico
Michigan
Indiana Registered Retail Merchant Number
BMV Dealer License Number
(10 digits + 3 digits)
(7 digits)
All nonresidents of the U.S.A.are
taxable.
Seller’s Affidavit
I certify under penalty of perjury, the information contained in this form is true, correct and complete to the best of my
knowledge and belief. A dealer who accepts an exemption certificate with the intention of helping the issuer unlawfully
avoid paying the state gross retail or use tax, commits a Class B misdemeanor per I.C. 6-2.5-9-1.
___________________________________________________
____________________________
Seller’s Signature
Date
Seller Instructions:
Desk Audit – Mail Stop #104
•
All lines must be completed or exemption is invalid. Dealer may be held
Indiana Department of Revenue
responsible for the sales tax if form is not fully completed.
100 N. Senate Ave., IGCN #241
•
Keep a copy of the ST-137RV for dealer documentation of exemption.
Indianapolis, IN 46204
•
Mail the original ST-137RV to the Department of Revenue at the address
shown within thirty (30) days of delivery.

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