SFN 2872 (7-2019)
Page 2 of 2
VII. Tax Exemption NDCC 57-40.3
(CONTINUATION OF MOTOR VEHICLE PURCHASER'S CERTIFICATE)
If vehicle is exempt from tax, enter number corresponding to exemption in Section IV. (front of this form)
1. Spouse
Grandparent(s)
Gift from: Parent(s)
Grandchild
Child
Sibling(s)
Gift to (Specify relationship between ALL NEW owners)
2. Joint Tenants with Right of Survivorship and now vehicle is being put in
one name only
3. Inheritance
4. Change of name by:
Marriage Adoption
Court Order
13. Tribal (SFN 18085 required)
14. Disabled American Veteran or Former Prisoner of War - Letter of
Eligibility from the Department of Veteran's Affairs is required
15. Nonprofit senior citizens' or mobility impaired persons' corporation
owned vehicle used for the transportation of the elderly or disabled
16. Mobility impaired person(s) purchasing specially equipped vehicle
17. Homemade vehicles
18. Newly formed
Partnership Corporation
Date formed:
19. Dissolved Partnership Corporation
Date dissolved:
20. Parochial or private non-profit school buses
21. Assembled vehicles by motor vehicle dealer (SFN 21859 required)
22. Transfer into family trust
23. Military home of record:
24. Mobile Home (SFN 3004 required) or Manufactured Home (SFN 53658
required)
Entry Discharge
(SFN 17147 required)
25. North Dakota political subdivisions
26. Repossession (SFN 2880 required)
27. Non-resident military lease
28. Total loss settlement or Salvaged
29. Other - Specify
(Check One)
(Check One)
5. Vehicle acquired through a lease purchase agreement (Check one)
A. If tax was paid on the total lease consideration, tax is due on the
lease buyout amount.
B. If tax was paid on the full purchase price and you have been in
possession of the vehicle over one year, no tax is due.
C. If tax was paid on the full purchase price and you have been in
possession of the vehicle for less than one year, tax is due on the
lease buyout amount.
6. State Fleet
7. Lien change --- CURRENT ODOMETER READING
8. Interstate carriers --- Account Number:
9. Tax paid to state that grants reciprocity to North Dakota (Proof required)
10. Public Transportation provided under contract with NDDOT
11. Dealer resale - USED vehicle
12. Dealer resale - NEW vehicle
VIII. Damage Disclosure NDCC 39-05-17.2
The damage disclosure law includes passenger cars, trucks, pickup trucks, motorcycles, and motor homes that are
less than nine years old. It EXCLUDES all trailers, off-highway vehicles, and snowmobiles. A Damage/Salvage Disclosure
Statement (SFN 18609) must be completed. Motor vehicle body damage disclosure requirements apply only to the transfer of
certificate of title on vehicles less than nine (9) model years old.
If applicable, please submit SFN 18609 Damage Disclosure Statement with this application.
Any person who makes a false statement on this form is guilty of a Class A Misdemeanor.
Instructions:
SECTION NO.
I. Check the type of application you are submitting (check only one).
II. Complete applicant information in FULL for each owner.
III. Complete ALL applicable vehicle information. Odometer reading required on all vehicles 10 years old and newer.
IV. Complete ALL applicable purchaser's certificate information.
• Abandoned vehicle disposal fee of $1.50 is due on all new and out-of-state passengers, trucks, buses, and
motorhomes when first titled in North Dakota.
• Title fee is $5.00.
• Enter license fee and pay applicable plate credit using the appropriate fee schedule.
• If applying plate credit, enter $5.00 plate transfer fee.
• If a trade allowance, year, make, and VIN are required.
• Enter the appropriate tax exemption number if an exemption for tax is claimed (see tax exemptions Section VII).
VI. Application must be signed with applicant's legal signature and dated.
VII. Applicable tax exemptions.
VIII. Damage Disclosure statement SFN 18609 must be completed for all vehicles less than nine (9) model years old.
V. Complete ALL applicable dealer and lienholder information. If needing to add a second lienholder complete
SFN 2475 Part 3: Purchaser's Certification and Application to include all lienholders.
