TENNESSEE DEPARTMENT OF REVENUE
TAXPAYER SERVICES DIVISION
APPLICATION FOR REFUND OF SALES TAX PAID ON THE
PURCHASE OF ALL-TERRAIN VEHICLES USED AS FARM EQUIPMENT
Name of Purchaser
Address
City, State, Zip Code
Telephone Number
Name of Dealer
Address
City, State, Zip Code
Telephone Number
Sales Tax Registration Number
Description of All-Terrain Vehicle (make)
(model)
(serial number)
Number of acres farmed (both owned and leased)
Specific types of crops or animals raised or grown for market:
Describe how the all-terrain vehicle is used in the farming operation:
What percentage of the vehicles operational time will be used for recreational purposes (hunting, fishing, camping, pleasure
riding, etc.):
I certify that the above is a true and complete statement to the best of my knowledge and ability. I understand that
falsification of information to obtain tax exemption may be punishable as provided by law.
Signed
Date
You must attach a legible copy of the purchase bill of sale or invoice and a copy of last years Schedule F of your IRS return
to confirm your eligibility to depreciate farm equipment. No consideration will be given to this application to refund tax
unless the copies are attached and the above fully completed. Our mailing address is : Tennessee Department of Revenue,
Taxpayer Services, Andrew Jackson State Office Building, Nashville, Tennessee, 37242.
The dealer is not authorized to provide tax exemption at the time of purchase. If your operation of the ATV qualifies for tax
exemption, you will be provided a letter certifying exemption. A copy will be sent to the dealer, who will refund the tax to you
and claim a credit on his next sales tax return.
RV-F1303501 (Rev. 5-99)