Interstate Tax Exemption Form

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The undersigned hereby certifies that it is or has contracted to, operate for the holder of a carrier permit, issued by the Interstate Commerce Commission, or it's successor agency, authorizing transportation by motor vehicle across the boundaries of this state. The undersigned further certifies that the motor truck or trailer to be constructed, repaired, cleaned, altered, or improved by you, or to which the subject matter of this purchase is to become a component part, will be used in direct connection with the business of transporting therein persons or property for hire; and that such sale and/or changes are exempt from the Retail Sales Tax under the provisions of RCW 82.08.0262. This certificate is given with full knowledge of, subject to, the legally prescribed penalties for fraud and tax evasion.
PERMIT NUMBER*
NAME OF CARRIER / PURCHASER*
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Address*
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