Form 5095 at a glance
What it is: Form 5095 is the Sales Tax Exemption Statement For Authorized Common Carriers.
Where and when to file: Mail to: Motor Vehicle Bureau P.O. Box 100 Jefferson City, MO 65105-0100.
A filled-in Form 5095 example: a carrier buys one truck
How to fill out Form 5095, box by box
Purchaser's (Lessor's) name, dates and address
Enter the Purchaser's (Lessor's) Name, Purchase Date (MM/DD/YYYY), Purchaser's (Lessor's) Telephone Number, Doing Business As, Lessee's Name, if applicable, Lease Date if applicable (MM/DD/YYYY), Purchaser's (Lessor's) Address and Lessee's Address, if applicable.
Common carrier registration (select one)
The purchaser is registered (or has a lease agreement with someone who is registered) as a common carrier to provide “for hire” services in (select one): Interstate commerce and is registered with the Federal Motor Carrier Safety Administration (FMCSA): provide the United States Department of Transportation (USDOT) registration number, if applicable, and the FMCSA operating authority (MC) number. Interstate commerce hauling exempt commodities and has filed the carrier's information with the FMCSA Safety and Fitness Electronic Records (SAFER) System: provide your USDOT registration number. Intrastate commerce and is registered with the Missouri Division of Motor Carrier Services: provide your USDOT registration number.
What the purchaser certifies
The purchaser (or individual named in the lease agreement) holds itself out to the public as engaging in “for hire” transportation of exempt commodities, passengers, or property of others; explain how the purchaser (or individual named in the lease agreement) holds itself out for hire to the public. The purchaser (or individual named in the lease agreement) will use the motor vehicle(s) or trailer(s) for the purpose noted herein. If a lease agreement is involved, the lease is for at least 30 days. Each motor vehicle will be registered for, and capable of hauling or carrying, at least 24,000 lbs. or more including vehicle weight, or registered as a commercial bus and capable of carrying eight or more passengers. If registering at a later date, provide the licensed gross weight to be applied for and the state of licensure for each motor vehicle or trailer.
Vehicle(s) Information
For each vehicle under Vehicle(s) Information, enter the Vehicle Identification Number (VIN), Purchase or Lease Date (MM/DD/YYYY), Year, Make, Model, Licensed Gross and State of Licensure.
Signature
Under Signature, enter the Typed or Printed Name and Date Signed (MM/DD/YYYY) with the Purchaser's (or Authorized Agent) Signature.
By signing I am affirming that the vehicles listed above meet the requirements for exemption as set forth by section 144.030, RSMo, and all regulatory requirements have been met, including verification of leases.
Under penalties of perjury, I declare that the information I have provided, and any attached supplement, is true, correct, and complete.
More rules for Form 5095
Visit http://dor.mo.gov/pdf/commoncarriers.pdf for additional information.
Common questions about Form 5095
Where do I file it?
Mail to: Motor Vehicle Bureau P.O. Box 100 Jefferson City, MO 65105-0100.
When is this form not the right one?
This form must be completed and submitted with each application for title in which the applicant is claiming a common carrier sales tax exemption. Applicants who do not qualify for the common carrier tax exemption who haul loads in excess of 54,000 lbs. must complete an Application for Sales Tax Exemption - Commercial Motor Vehicles or Trailers Greater than 54,000 Pounds (Form 5435), to apply for an exemption from sales tax.
Sources
[1] Form 5095 (Revised 06-2026), Sales Tax Exemption Statement For Authorized Common Carriers, Missouri Department of Revenue (the Official source link on this page).