THIS FORM IS TO BE KEPT IN THE SELLER’S FILES
DR 0780 (10/22/09)
COLORadO dEPaRTMENT OF REvENuE
Denver, CO 80261
303-238-7378
STaTEMENT OF COLORadO SaLES Tax ExEMPTION
FOR MOTOR vEHICLE PuRCHaSE
Vehicles delivered to a nonresident of Colorado to be licensed outside the state of Colorado are exempt from Colorado
sales tax under the provisions of 39-26-113(5) or 39-26-719(2)(a) C.R.S., as amended. The vehicle is not to be licensed
or registered in Colorado and must be removed from the state of Colorado within thirty (30) days of purchase.
Type of vehicle purchased:
Automobile (notarization not required)
Truck-tractor
Trailer
Recreational Vehicle
Truck
Truck bed
Semi-trailer
Year
Make
Vehicle Identification Number
Purchase Date
Net Sales Price
Purchaser’s Name
Purchaser’s Address
City
ZIP
Purchaser is a resident of (state)
Dealer’s Name
Dealer’s Address
The purchaser hereby swears that the above described vehicle will be removed from Colorado within thirty (30)
days from the date of purchase and that the vehicle will be licensed, registered and used outside of Colorado or in
interstate commerce.
Signature of Purchaser
Date