1. Clear form
Utah State Tax Commission
TC-706
Statement of Compliance Rev. 7/99
Motor Vehicles Not Manufactured For Sale in the United States
Division of Motor Vehicle · 210 North 1950 West · Salt Lake City, Utah 84134 · (801) 297-7780 or 1-800-368-8824
Vehicle Identification number Year Make Body style
Country of origin Entry date
Port of entry
Name (please print) Address (street, city, state, zip code)
I certify the following:
1. The vehicle described above has properly cleared U.S. Customs in accordance with the Tariff Act 1930, as amended, the
Customs Procedural Reform and Simplification Act 1978, and the Trade Agreement Act of 1979. The port of entry
information above is correct.
2. The vehicle has been modified to comply with applicable Federal Motor Safety Standards (FMVSS) in effect on the date
manufactured.
3. Check one:
The vehicle described above has been brought into compliance with all requirements of the United States
Clean Air Act and meets the U.S. pollution standards in effect when it was manufactured; or
The vehicle is not required to comply with United States Clean Air Act because of Personal Importation One Time
Exception provision allowed by Federal rules.
I/We further state that to my/our knowledge, the vehicle is free and clear of any liens, encumbrances, lawful claims, and/or demands of
any person whatsoever, except as shown on the attached application for title and registration, and the vehicle is not involved in any
existing or pending litigation.
The fair market value of the vehicle is $ ________________________.
The total purchase price of this vehicle in U. S. currency was $ ________________________.
In consideration of issuing a certificate of title on the above described vehicle, I/We hereby agree to indemnify the Utah State Tax
Commission and all persons acting under its direction from any and all liability and shall defend, at my/our expense all litigation which may
arise as a result of the issuance of the certificate of title.
Under the penalty of perjury, I certify that the information certified to and stated above is true and correct to the best of my knowledge.
Date
Signature
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