51A270 (1-21) Certificate of Sales Tax Paid DEPARTMENT OF ... - Kentucky

51A270 (1-21)

Commonwealth of Kentucky DEPARTMENT OF REVENUE

NAME OF DEALER

Dealer's FEIN (Federal Identification Number, 9 digits)

Certificate of Sales Tax Paid on the Purchase of a Motor Vehicle

Motor Vehicle Dealer Number

DATE OF SALE

Dealer's KY Sales and Use Tax Permit Account Number (6 digits)

Address of Dealer

City

NAME OF PURCHASER(S) (PRINT OR TYPE)

State

ZIP Code

Address of Purchaser

City

State

Vehicle Identification Information of Purchase

VIN (Vehicle Identification Number)

Year

Make

ZIP Code Model

Calculation of Sales Tax

Trade-in Information

VIN (Vehicle Identification Number) 1. Total Selling Price............................ ___________________

2. Trade-in Allowance.......................... ___________________

(Like-kind exchanges only)

Year

Make

Model

3. Amount Subject to Tax..................... ___________________ (Line 1 minus Line 2)

4. Amount of Tax Collected.................. ___________________ (Line 3 multiplied by 6% (.06))

Under penalties of perjury, I hereby certify that the information shown on this certificate is true and correct, and the amount of Kentucky sales tax was collected from the purchaser for remittance to the Department of Revenue.

Authorized Signature of Seller__________________________________ Title_______________________________________________________ Date______________________________________________________

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