Fillable Bill Of Sale (For A Vehicle Claimed As A Tax Credit Towards The Purchase Of A Replacement Vehicle)

Bill Of Sale (For A Vehicle Claimed As A Tax Credit Towards The Purchase Of A Replacement Vehicle) - Arkansas

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Arkansas Department of Finance and Administration

Revenue Division

_______________________________________________________

Bill of Sale

(For a vehicle claimed as a tax credit towards the purchase of a replacement vehicle)

Purchaser(s) Name(s)

Phone Number

Address

City, State, Zip

Seller(s) Names

Phone Number

Address

City, State, Zip

Year, Make, Model of Vehicle Sold

Vehicle Identification Number (VIN)

Odometer Reading

Date Vehicle Sold

Sale Price

Purchaser’s Acknowledgement: I (we) hereby swear and affirm that the above information is true and correct. I

understand that any attempt to evade or defeat the payment of the proper amount of tax on the aforementioned

vehicle by making any false statement is a felony under Arkansas law punishable by fine, imprisonment, or both.

Signature of Purchaser(s)

Date

Seller’s Acknowledgement: I (we) hereby swear and affirm that the above information is true

and correct, and that said vehicle was owned and sold by me, and that I am entitled to a reduction

in the taxable price of a newly acquired vehicle under the provisions of Act 1232 of 1997, as

amended. I understand that any attempt to evade or defeat the payment of the proper amount of

tax by making any false statement is a felony under Arkansas law punishable by fine,

imprisonment, or both.

Signature of Seller(s)

Date

Bill Of Sale (For A Vehicle Claimed As A Tax Credit Towards The Purchase Of A Replacement Vehicle) - Arkansas

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