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GT-500003

Suggested Format for Affidavit for Exemption of Boat Sold for Removal

N. 06/98

from the State of Florida by a Nonresident Purchaser

The following is a suggested format for an affidavit to be completed by the purchaser and furnished to the selling dealer. In order to

satisfy the requirements for exemption, the affidavit must contain all of this information and be completed in full.

STATE OF ________________ COUNTY OF __________________________

*** READ CAREFULLY BEFORE SIGNING ***

Before me this day personally appeared the below named affiant who, being duly sworn, deposes and says:

1. I have read the Florida Department of Revenue Rule 12A-1.007(9), Florida Administrative Code, and § 212.05,

Florida Statutes (F.S.); and

2. I am not a resident of the State of Florida and did not make my permanent place of abode in Florida at the time of

taking delivery of the boat designated below; and

3. I am not engaged in Florida in any employment, trade, business, or profession for which the designated boat will

be used in Florida; and

4. I represent a corporation which has no officer or director who is a resident of, or makes his or her permanent place

of abode in Florida; and

5. I represent an artificial entity other than a corporation which has no individual vested with authority to participate

in the management, direction, or control of the affairs of the entity who is a resident of Florida, or makes his or her

permanent place of abode in Florida; and

6. Within 30 days of the date of departure from Florida of the herein described boat, I agree to furnish the Florida

Department of Revenue with written proof that this vessel was licensed, titled, registered or documented outside

Florida; and

7. Within 10 days of the date of departure of the herein described vessel, I agree to furnish the Florida Department

of Revenue with invoices for fuel, dockage charges, or repairs issued by out-of-state vendors or suppliers or

other documentary evidence which specifically identifies this boat, including the hull ID number; and

8. I claim exemption under § 212.05(1)(a)2., F.S., from Florida sales and use tax on the purchase of the boat

designated below for the following reason:

Boat herein identified and described is 5 net tons of admeasurement or larger and I plan to have the boat in Florida

for a period up to 90 days from the date of purchase. I hereby agree to purchase from the selling dealer, at the time

of sale, a decal issued by the Florida Department of Revenue authorizing the boat to remain in Florida up to 90

days following the date of sale. I further agree to remove the boat from Florida within the 90 day period

authorized by the decal and understand that the 90 day period may not be tolled for any reason including repairs.

Boat will be removed by me or by my designated agent from the State of Florida within 10 days of the date of

purchase.

Boat is to be repaired or altered and will be removed from the State of Florida by me or by my designated agent

within 20 days (excluding tolled days) after completion of the repairs or alterations consistent with § 212.05, F.S.

PLEASE TYPE OR PRINT THE FOLLOWING INFORMATION:

Name of Purchaser ___________________________________________________________________________________________

If Purchaser is a Corporation or Partnership, List Corporate Officers or Partners ___________________________________________

__________________________________________________________________________________________________________

Purchaser’s Permanent Address (Street)___________________________________________________________________________

(City) _____________________________________________ (State/Country) ___________________ (ZIP) ___________________

Purchaser’s Daytime Telephone Number ( _____ ) ___________________

Purchaser’s Driver’s License Number and State of Issuance ___________________________________________________________

Purchaser’s Passport or Visa Number ____________________________________________________________________________

Name of Selling Dealer _______________________________________________________________________________________

Address of Selling Dealer (Street) _______________________________________________________________________________

(City) _____________________________________________ (State/Country) ___________________ (ZIP) ___________________

Selling Dealer’s Florida Sales and Use Tax Registration Number _______________________________________________________

Dealer’s Telephone Number ( _____ ) _____________________

Date of Sale (Month) _______________ (Day) __________ (Year) ________________

Form Gt-500003 - Suggested Format For Affidavit For Exemption Of Boat Sold For Removal From The State Of Florida By A Nonresident Purchaser

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