Schedule A/e - Vehicle Deletion Information - South Dakota Department Of Revenue

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Schedule A/E
GENERAL INFORMATION
SIGNATURE
Application Type (Check all that may apply)
BY SIGNING THIS DOCUMENT, I CERTIFY THAT ALL THE STATEMENTS ARE TRUE AND CORRECT AND THAT I
CAN BE HELD LIABLE IF THE INFORMATION GIVEN IS FOUND TO BE INCORRECT.
Add Vehicle
Delete Vehicle
Increase Weights
Add Jurisdiction
Signature
Date
License Year
IRP Account Number
Supp. #
Fleet Number
Name of Registrant
Contact Name and Phone Number
If deleting a unit, the plate and cab card MUST be returned to receive credit or a refund. You must also
indicate below if you want a South Dakota Refund or a transfer of fees to a new unit.
VEHICLE DELETION INFORMATION
1
2
3
4
5
6
7
8
Vehicle
Vehicle ID Number
Combined
License
Replacement
Unit#
Year
Make
(As Shown on Title)
Gross
Plate
Unit #
Reason Removed
Weight
Number
South Dakota Department of Revenue
Office of Prorate and Commercial Licenses
445 East Capitol Avenue
Pierre, South Dakota 57501-3185
Telephone: (605) 773-3314
Fax: (605) 773-8416
Please specify for unused licensing fee(s) for vehicle(s) above:
SD Refund
Transfer
Transfer Vehicles:
From Unit
To Unit
From Unit
To Unit
From Unit
To Unit
From Unit
To Unit
(01-2010)
PR-IRP 4

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