Form St-137rv - Affi Davit Of Exemption By A Nonresident Of Indiana On The Purchase Of A Recreational Vehicle Or Cargo Trailer

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Indiana Department of Revenue
ST-137RV
State Form 52705
Affi davit of Exemption by a Nonresident of Indiana
(R3 / 8-13)
on the Purchase of a Recreational Vehicle or Cargo Trailer
(where physical delivery is accepted within Indiana by the purchaser)
Purchaser’s Information
Name of Purchaser
Social Security or Federal Identifi cation Number (mandatory)
Address
City
State
Zip Code
Purchaser’s Affi davit
I understand that a person who issues an exemption certifi cate, with the intention of unlawfully avoiding the payment of the state gross
retail or use tax, commits a Class B misdemeanor, per IC 6-2.5-9-1.
I hereby certify under penalty of perjury:
• Purchaser is not a resident of the state of Indiana.
• Purchaser is a legal resident of ______________________________________________ .
• The recreational vehicle or cargo trailer described below will be removed from the state of Indiana, by the purchaser, within 30 days
to be registered/titled in _________________________________________ .
_________________________________________________________________________
_________________________
Purchaser/Agent’s Signature (indicate if an agent for the buyer – see instructions)
Date
Primary Operator’s Driver License Number_______________________________________
State of __________________
Description of Purchase
□
□
Year
Make
□
New
Used
□
Recreational Vehicle
Model
VIN
Cargo Trailer*
*Kentucky, Maine and Rhode Island
Total Selling Price
Trade Allowance Value
residents must pay Indiana Sales Tax on
Cargo Trailers.
Seller’s Information
Name of Licensed Dealer/Seller
Tax must be collected if purchaser is a resident of
a state/country listed below.
Address
Arizona
Michigan
California
Mississippi
City
Florida
North Carolina
Hawaii
South Carolina
State
Zip Code
Massachusetts
Indiana Registered Retail Merchant
BMV Dealer License Number
All nonresidents of the USA are subject to sales
Number (10 digits + 3 digits)
(7 digits)
tax, except Canadian residents.
Seller’s Affi davit
I certify under penalty of perjury, the information contained in this form is true, correct and complete to the best of my knowledge and
belief. A dealer who accepts an exemption certifi cate with the intention of helping the issuer unlawfully avoid paying the state gross
retail or use tax, commits a Class B misdemeanor per IC 6-2.5-9-1.
_________________________________________________________
________________________________
Seller’s Signature
Date
Seller Instructions:
Mail to:
• All lines must be completed or exemption is invalid. Dealer may
Indiana Department of Revenue
be held responsible for the sales tax if form is not fully complet-
Desk Audit – Mail Stop 104
ed.
100 N. Senate Ave.
• Keep a copy of the ST-137RV for dealer documentation of
Indianapolis, IN 46204
exemption.
• Mail the original ST-137RV to the Department of Revenue at
the address shown within thirty (30) days of delivery.

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