Certificate Of Gross Retail Or Use Tax Paid (St-108, Indiana Department )

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Indiana Department of Revenue
Form
ST-108
Certificate of Gross Retail or Use Tax
State Form 48842
Paid on the Purchase of a
(R2 / 3-08)
Motor Vehicle or Watercraft
Dealer’s RRMC #
NAME OF DEALER
(Registered Retail Merchant Certificate Number)
TID# (10 digits)
LOC# ( 3 digits)
Dealer’s FID #
Dealer’s License Number (seven digits)
(Federal Identification Number, 9 digits)
Address of Dealer
City
State
Zip Code
NAME OF PURChASER(S) (PRINT OR TYPE)
Address of Purchaser
City
State
Zip Code
Vehicle Identification Information of Purchase
VIN #
or HIN # (
Year
Make
Model/Length
(Vehicle Identification Number)
Hull Identification Number)
Trade In Information
Calculation Of Sales/Use Tax
1. Total Selling Price ..............................
1.
VIN #
or HIN #
(Vehicle Identification Number)
(Hull Identification Number)
2. Trade-In Allowance
(Like-kind exchanges only) ................
2.
Year
Make
Model/Length
3. Amount subject to tax
(Line 1 minus Line 2) .........................
3.
4. Amount of tax collected
(Line 3 multiplied by 7% (.07) ...........
4.
I hereby certify that the information shown on this certificate is true and correct, and the amount of Gross Retail Sales/Use Tax was collected from the
purchaser. I also understand that any false information may result in the revocation of my Gross Retail Sales/Use Tax Certificate.
Date:
Printed Name of Seller:
Signature of Seller:
Title:

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