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MINNESOTA DEPARTMENT OF PUBLIC SAFETY DRIVER AND VEHICLE SERVICES 445 Minnesota Street, St. Paul, MN 55101-5187
M o tor V e h i c l e G ift Affid av it For m This form is for use when claiming exemption from motor vehicle sales tax in a gift transaction, pursuant to Minnesota Statutes 297B.
• Print and mail this completed application to Driver and Vehicle Services, 445 Minnesota Street, St. Paul, Minnesota 55101-5187. It may also be submitted to any Deputy Registrar motor vehicle office statewide.
• The certificate of title, and all applicable documents and fees, are required to be submitted with this form. • If you have questions or need additional information, please contact DVS at (651) 297-2126 or (651) 282-6555 (TTY). • NOTE: If purchaser has a security agreement (lien) on the vehicle, a signed explanation is required. The transfer may be subject to sales tax.
Describe the vehicle below. (PRINT OR TYPE)
Year
Make
Vehicle Identification Number (if not registered in Minnesota)
OR
Current Plate Number
I (we), Seller(s) Name(s) (FIRST, MIDDLE, LAST) and I (we) Buyer(s) Name(s) (FIRST, MIDDLE, LAST)
certify that the above-described vehicle was a gift between the above-named individuals. We further certify that the transfer was for no monetary or other consideration or expectation of consideration. I (we) understand that preparing, completing, or submitting a false or fraudulent motor vehicle sales tax declaration is a gross misdemeanor, or, if the tax involved exceeds $300, is a felony, pursuant to Minnesota Statutes 297B.10 for Penalties.
X
Seller’s Signature(s) – all sellers must sign Signed and attested (date)
Before me on
X
.
Notary or Deputy Signature
County
State
My Commission expires
Notary or Deputy Stamp
My Commission expires
Notary or Deputy Stamp
X
Buyer's Signature(s) – all buyers must sign Signed and attested (date)
Before me on
X
.
Notary or Deputy Signature
County PS2080 B-07 (02/12)
State
