Dealer'S Sales Tax Statement - Boats printable pdf download

Dealer'S Sales Tax Statement - Boats

DR-41C

Dealer’s Sales Tax Statement – Boats

R. 04/01

Date: ________________

I hereby certify that the sales tax due under Chapter 212, Florida Statutes, has been paid by the purchaser on the boat described

herein:

Purchaser’s Name: ___________________________________________________________________________________________

Address: ___________________________________________________________________________________________________

City: _________________________________ State: ________ ZIP: ________________ Phone: (

) _______________________

Previous Owner’s Name: _______________________________________________________________________________________

Address: ___________________________________________________________________________________________________

City: _________________________________ State: ________ ZIP: ________________ Phone: (

) _______________________

Description-Make: _________________________________ Model: ___________________ Hull Number: _____________________

State Registration and/or Documentation Number: __________________________________________________________________

Length: ________________ Beam: _______________________ Vessel Name: ___________________________________________

❏ Inboard

❏ Outboard

❏ Sail

❏ Other

Type (check one):

Date Purchased: ___________________ Purchase Price: $ _____________________ Tax Collected: $ ________________________

Dealer’s Name: ______________________________________________________________________________________________

Address: ___________________________________________________________________________________________________

City: _________________________________ State: ________ ZIP: ________________ Phone: (

) _______________________

Certificate of Registration Number: _______________________________________________________________________________

Signature: __________________________________________________________________________________________________

This form is not valid unless completed in its entirety, signed by selling dealer, and the dealer’s sales tax certificate of

registration number shown.

Dealer'S Sales Tax Statement - Boats