Form Rv-F1300901 - Seller/purchaser Affidavit Of Exemption For Motor Vehicles, Boats, And Vessels Sold For Removal From Tennessee Within Three Days

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TENNESSEE DEPARTMENT OF REVENUE
SELLER/PURCHASER AFFIDAVIT OF EXEMPTION FOR MOTOR VEHICLES, BOATS,
AND VESSELS SOLD FOR REMOVAL FROM TENNESSEE WITHIN THREE DAYS
(SECTIONS A AND B TO BE COMPLETED BY SELLER)
SECTION A:
1. Trade name of seller
2. Address
State
Zip Code
3. City
4. Sales and Use Tax registration number
5. Seller’s telephone number
SECTION B: DESCRIPTION OF MOTOR VEHICLE OR BOAT
6. This article is a ( ) motor vehicle or ( ) boat
7. Make
Model
Year
8. Serial Number
Motor Number
9. (Boats only) Trailer Serial Number
Trade-in $
10. Selling Price $
Date
11. Invoice Number
I certify that, to the best of my knowledge, the article described above will be removed from the state of Tennessee by the
purchaser described below within three days from date of purchase.
Date
(Signature of dealer or authorized representative)
SECTION C: (TO BE COMPLETED BY PURCHASER)
Under penalties of perjury, I certify that the article described above is being purchased for removal from the state of Tennessee
within three days from date of purchase. I understand that any
to the state of
attempts to title or register this article in Tennessee will subject me to the appropriate sales or use tax.
1. Name of purchaser
2. Address
State
3. City
Zip Code
Date
(Signature of Purchaser)
INSTRUCTIONS: This form must be completed in duplicate. The copy is to be provided to the purchaser and the original
retained in the seller’s file as a part of the transaction documents. DO NOT ATTACH THIS TO YOUR SALES AND USE TAX
RETURNS OR MAIL THE FORM TO THE DEPARTMENT OF REVENUE.
RV-F1300901 (Rev. 12-10)

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