Form Hsmv 82039 – Fill Out and Use This PDF

6	SALES TAX EXEMPTION CERTIFICATION

I CERTIFY THE MOTOR VEHICLES, MOBILE HOMES OR VESSELS (DESCRIBED ON SIDE 1 SIDE OF THIS FORM) HAVE BEEN PURCHASED AND IS EXEMPT FROM THE SALES TAX IMPOSED BY CHAPTER 212, FLORIDA STATUTES BECAUSE:

PURCHASER (STATE AGENCIES, COUNTIES, ETC.) HOLDS VALID EXEMPTION CERTIFICATE ______________________________________________________

CONSUMER’S CERTIFICATE OF EXEMPTION NO.

7		DEALER SALES TAX REPORT
FLORIDA SALES TAX REG NUMBER	DATE OF SALE	DEALER LICENSE NUMBER	AMOUNT OF TAX, PER UNIT	DEALER / AGENT SIGNATURE
8		CERTIFICATION

THE FOLLOWING CERTIFICATIONS ARE MADE BY THE APPLICANT:

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IN CONSIDERATION OF THE FOREGOING AND THE ATTACHED EVIDENCE OF MY/OUR OWNERSHIP OF THE MOTOR VEHICLES, MOBILE HOMES OR VESSELS DESCRIBED ON SIDE 1 OF THIS FORM, I/WE REQUEST THAT THE CERTIFICATE OF TITLE BE ISSUED IN TO MY/OUR NAME.

I/WE FURTHER AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS.

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.

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Signature of Applicant (Owner)Printed NameDate

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Signature of Co-Applicant (Co-Owner)Printed NameDate

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WHO IS AUTHORIZED TO COMPLETE THIS FORM?:

ANY AUTHORIZED AGENT OF A COMPANY OR CORPORATION, REQUIRED TO MAKE APPLICATION FOR MULTIPLE FLORIDA CERTIFICATES OF TITLE.

WHEN SHOULD THIS FORM BE USED?:

WHEN A COMPANY OR CORPORATION IS APPLYING FOR MULTIPLE CERTIFICATES OF TITLE ON NEW OR USED MOTOR VEHICLES, MOBILE HOMES OR VESSELS WITH THE SAME YEAR, MAKE, BODY AND WEIGHT. FOR MOBILE HOMES AND VESSELS, BODY AND WEIGHT ARE EXCLUDED AND LENGTH IS INCLUDED.

WHEN IS THE VIN VERIFICATION ON THIS FORM NOT NECESSARY?:

THE VIN VERIFICATION ON THIS FORM DOES NOT HAVE TO BE COMPLETED ON VESSELS, MOBILE HOMES, TRAVEL TRAILERS, CAMPING TRAILERS, FIFTH WHEEL RECREATIONAL TRAILERS OR SEMI TRAILERS WITH A NET WEIGHT OF LESS THAN 2,000 POUNDS, WHEN A FLORIDA CERTIFICATE OF TITLE IS SUBMITTED AS PROOF OF OWNERSHIP OR WHEN FORM HSMV 82042 HAS BEEN COMPLETED AND IS ATTACHED.

WHEN IS THE ODOMETER DECLARATION ON THIS FORM NOT NECESSARY?:

THE ODOMETER DECLARATION IN SECTION 4 OF THIS FORM DOES NOT HAVE TO BE COMPLETED WHEN THE VEHICLE BEING TITLED IS EXEMPT FROM ODOMETER DISCLOSURE REQUIREMENTS. EXEMPTIONS: WHEN THE VEHICLE IS TEN YEARS OLD OR OLDER, HAS A GROSS VEHICLE WEIGHT (GVWR) OF MORE THAN 16,000 POUNDS OR IS NOT SELF PROPELLED.

ODOMETER STATUS

∗A - WHEN A CHECK MARK IS ENTERED UNDER THE “A” THE STATUS WILL BE SHOWN AS “ACTUAL MILEAGE.”

∗N - WHEN A CHECK MARK IS ENTERED UNDER THE “N” THE STATUS WILL BE SHOWN AS “WARNING: NOT ACTUAL MILEAGE.”

∗E - WHEN A CHECK MARK IS ENTERED UNDER THE “E” THE STATUS WILL BE SHOWN AS “EXCEEDS MECHANICAL LIMITS.”

FILING:

1.ALL APPLICABLE SECTIONS OF THIS FORM MUST BE COMPLETED LEGIBLY.

2.ONE OF THE FOLLOWING MUST BE FILED WITH THIS FORM.

(A)FLORIDA CERTIFICATE OF TITLE. (OR)

(B)MANUFACTURER’S CERTIFICATE OF ORIGIN. (OR)

(C)OUT-OF-STATE TITLE OR OTHER OFFICIAL PROOF OF OWNERSHIP.

3.THIS FORM MUST BE SIGNED BY AND INCLUDE THE PRINTED NAME OF AN AUTHORIZED AGENT OF THE COMPANY OR CORPORATION.

SALES TAX

THE SALES TAX EXEMPTION NUMBER OR CONSUMER’S CERTIFICATE OF EXEMPTION NUMBER MUST BE SHOWN IN SECTION 6 OF THIS FORM.

NOTE: FORMS DR40, DR-41A AND FORM HSMV 82042 HAVE BEEN MERGED INTO THIS FORM.

Check your local phone book government pages or visit the following website for current mailing addresses: http://www.flhsmv.gov/offices/

HSMV 82039 (Rev. 12/11) S

www.flhsmv.gov