MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
445 Minnesota Street, St. Paul, MN 55101
Motor Vehicle Sales Tax Affidavit (Declaration)
This form is for use when claiming below fair market value purchase price, pursuant to Minnesota Statutes 297B.
• Print and mail this completed application to Driver and Vehicle Services, 445 Minnesota Street, St. Paul, Minnesota
55101-5187. It may also be submitted to any Deputy Registrar motor vehicle office statewide.
• The certificate of title, and all applicable documents and fees, are required to be submitted with this form.
• If you have questions or need additional information, please contact DVS at (651) 297-2126 or (651) 282-6555 (TTY).
• Original receipts may be required.
• NOTE: If purchaser has a security agreement (lien) on the vehicle, a signed explanation is required. The transfer may be
subject to sales tax.
Describe the vehicle below:
Year
Make
Vehicle Identification Number (if not registered in Minnesota)
OR
Current Plate Number
I (we),
Buyer(s) Name(s) (FIRST, MIDDLE, LAST)
certify that the above-described vehicle needs the following repairs. DO NOT list normal wear and maintenance (for example,
tires, brakes, etc.), as it cannot be considered in reducing the purchase price.
Specific Repairs Needed Cost of Each Repair
I (we) understand that preparing, completing, or submitting a false or fraudulent motor vehicle sales tax declaration is a gross
misdemeanor, or, if the tax involved exceeds $300, is a felony.
X
Signature
PS2080A-08 (10/13)
