Form 73a054 - Kentucky Application For Dealer Loaner/rental Vehicle Tax
ADVERTISEMENT
1
273A054 (8-06)
FOR OFFICIAL USE ONLY
KENTUCKY APPLICATION FOR
Commonwealth of Kentucky
DEALER LOANER/RENTAL VEHICLE TAX
DEPARTMENT OF REVENUE
Mail completed application to the Kentucky Department of Revenue,
Motor Vehicle Usage Tax Section, P O Box 1303, Station 64, Frankfort, KY 40602-1303
Enter Legal Name
Current MVC
Name of
Dealer Number
Business
Location of
Business
Number and Street
City
County
State
ZIP Code
Mailing
Address
P.O. Box or Number and Street
City
County
State
ZIP Code
Account Number
(
)
_
Kentucky Employer’s Withholding __________________________
Telephone Number
Business
Kentucky Corporation Income and License __________________________
Information
(
)
_
Kentucky Sales and Use __________________________
Fax Number
_
Kentucky Unemployment Insurance __________________________
Federal Employer I.D. Number
Name of Owner
Title
Social Security Number or FEIN
Home Address
Telephone Number
Owner
Information
Name of Co-Owner
Title
Social Security Number or FEIN
Home Address
Telephone Number
Contact
(
)
_
Person
Contact Name
Contact Telephone Number
Contact E-Mail Address
1.
Does your dealership furnish repair services to your customers?
Yes
No
Eligibility
2.
Do you loan or rent vehicles to the customers while repairing their vehicle?
Yes
No
If no, stop, sign and return this application to the Kentucky Department of Revenue.
If yes, continue.
3.
Submit a list of the vehicles you use as loaners/rentals on the reverse of this form.
The above statements are hereby certified to be correct to the best knowledge and belief of the undersigned who is duly authorized to sign
this application.
__________________________________
_______________________________
__________________
Signature of Owner or Partner
Title
Date
(If a corporation, an officer must sign)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial