Form 631 - Vehicle Rental Tax Government Use Exemption Certificate
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Alaska
631
Vehicle Rental Tax
Government Use Exemption Certificate
AS 43.52
THIS FORM IS TO BE FILLED OUT BY RENTAL AGENCY AND SIGNED BY RENTER/CUSTOMER.
Purpose of Form: TO CERTIFY THAT THE VEHICLE IS RENTED TO A PERSON FOR EXEMPT OFFICIAL USE.
Rental/Lease Contract Number
Government Agency Exemption Category: Check one & enter the name & telephone number of the agency. Be specific on the agency
name. For example, write State of Alaska Department of Revenue, not just State of Alaska.
Federal Agency *:
Agency Phone #:
State Agency:
Agency Phone #:
Local Agency:
Agency Phone #:
Foreign Agency:
Agency Phone #:
(A tax exemption card issued by the United States Department
of State is required)
* A federal agency includes instrumentalities of the federal government such as the following: Federal Land Banks, Federal Deposit
Insurance Corporations, Commodity Credit Corporations, Federal Farm Mortgage Corporation, Federal Home Loan Banks, Central
Bank of Cooperatives, Federal Intermediate Credit Bank, Federal Reserve Bank, Federal Savings and Loan Insurance Corporation,
Student Loan Marketing Association, Federal Credit Unions, National Railroad Passenger Corporations, and American Red Cross.
Rental Agency: You must attest to having seen proof of the renter’s employment or official status.
INITIAL
one box:
Picture identification card issued by or on behalf of an exempt agency
Business card of individual, embossed with seal of exempt agency
Direct billing to agency/credit card of agency
Travel or purchase order issued by an exempt agency
Renters Sworn Statement
I declare under penalty of perjury that I have examined this certificate and to the best of my knowledge and belief it is true and
complete, and I certify that the rented or leased vehicle has been authorized by, and will be used for the exempt purposes of,
the agency named herein. I understand that if the rented vehicle is not for official use of the exempt agency, I am liable for
the applicable tax.
Renter Signature
Renter Printed Name
Date
This form is available online at
Rental Agency: Do not send this exemption certificate to the Department of Revenue
Keep ORIGINAL on file for three years
631
0405-631 Rev 12/12
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