1. Clear form
Utah State Tax Commission
210 N 1950 W • Salt Lake City, UT 84134 • www.tax.utah.gov
TC-719
Sales and Use Tax Exemption Affidavit Rev. 5/07
for Authorized Interstate Carriers
Purchaser or Lessee Information
Purchaser/Lessee name Purchase/Lease date
Purchaser/Lessee address Telephone number
The purchaser/lessee or operator certifies the following:
For Purchaser/Lessee of Vehicles
The purchased/leased vehicle is a qualified vehicle under IFTA and IRP requirements (over 26,000 pounds or three axles), and
will be operated pursuant to the International Registration Plan (IRP) and the International Fuel Tax Agreement (IFTA). Qualified
vehicles do not include recreational or passenger vehicles.
Purchaser/Lessee’s Purchaser/Lessee’s
IRP account number: ___________________ AND IFTA account number: _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ __
For Purchaser/Lessee of Aircraft
Purchaser/Lessee is the holder of a certificate issued by the Federal Aviation Administration (FAA) authorizing the holder to engage in
interstate commerce.
FAA operating certificate / air carrier operating certificate number: _ _ _ _ _ _ _ _ _ _
_________
For Purchaser/Lessee of Locomotive, Freight Cars, Railroad Equipment, and Other Rolling Stock
Purchaser/Lessee is the holder of a certificate issued by the United States Department of Transportation Surface Transportation Board
authorizing the holder to engage in interstate commerce.
Surface Transportation Board certificate number: _ _ _ _ _ _ _ _ _ _
_________
Under penalties of perjury, the information contained in this affidavit is true, correct and complete.
X
____________________________ _ _ _ _ _ _
_______ ________
_______
Purchaser/Lessee’s (or authorized agent’s) signature Date
Seller/Lessor Information
Seller/Lessor’s name Dealer number (sales tax acct. #, if lessor)
Seller/Lessor’s address
Vehicle/Aircraft/Equipment Information If you are purchasing more than space allows below, attach a separate listing.
Vehicle/Aircraft/Equipment Identification # Year Make Model
ORIGINAL to the Utah State Tax Commission at the point of registration. If unit is sold by a Utah bonded motor vehicle dealer, attach copy to the Dealer
Report of Sale. Seller/Dealer/Purchaser: Make copies for your records.
If you have questions, call (801) 297-7705 or toll free 1-800-662-4335 ext. 7705. If you need an accommodation under the Americans with Disabilities Act, contact
the Tax Commission at (801) 297-3811 or (TDD) Telecommunications Device for the Deaf (801) 297-2020. Please allow three working days for a response.