Audit
Form ST-7R
Massachusetts
Motor Vehicle Certificate
Department of
of Payment of Sales or Use Tax
Revenue
Purchaser’s Name
Purchaser’s Address
Description of Motor Vehicle or Trailer Sold:
Year of model
Make
Model Name
Type
Vehicle Identification No.
Date of Sale
A. Sale by Licensed Motor Vehicle Dealer
(Dealer must complete this schedule.)
Gross Sales Price
$ ______________
$
Less: Manufacturer’s Excise (Sec. 4061 (A) of IRC)
______________
(applies to new motor vehicles only)
Net Sales Price
$ ______________
Less: Trade-in Allowance, if any, for A: Year 19 ____
$ ______________
Make _____________________ Vehicle Ident. No. _____________________
$
______________
Taxable Sales Price
$ ______________
Sales Tax Received (Taxable sales price x .05)
$ ______________
B. Sale by a Person Other Than a Motor Vehicle Dealer
Gross Sales Price
$ ______________
Use Tax (Gross sales price x .05)
$ ______________
I declare under the penalties of perjury that this certificate has been examined by me and to the best of my
knowledge and belief is complete, and the statements made herein are true and correct.
Purchaser:
Firm Name (if any)
Date
Signature
Title
Seller (Seller must also sign):
Firm Name (if any)
License No. (if dealer)
Signature
Title
Address
Sales and Use Tax Registration No.
Subject to verification and assessment by the Department of Revenue. Erroneous information will result in
suspension of registration. Make check or money order payable to the Commonwealth of Massachusetts.
Tax payment received in the amount entered in A or B above:
NUMBER _____________________________ DATE _____________________________
REGISTRAR OF MOTOR VEHICLES.
COPY FOR: MOTOR VEHICLE DEALER’S (OR OTHER SELLER’S) RECORDS, TO BE RETAINED AS
EVIDENCE OF TAX PAYMENT
Form ST-7R 30M 4/98 G698C49