Washington Buyer’s Affidavit for In-State Delivery of Motor Vehicles

Buyer’s Affidavit for In-State Delivery of Motor Vehicles 
Buyer's Affidavit for In-State Delivery of Motor Vehicles
Buyer’s Affidavit of In-State Delivery of Motor Vehicles

Form 27 0002

Buyer’s Affidavit for In-State Delivery
of Motor Vehicles

To be completed by a buyer when the vehicle is delivered to a buyer within
Washington state.

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1 Buyer information
Name:
Resident state:
Home address:
City:

State:

Zip:

2 Vehicle information
Purchase date:

Seller name:

Make:

Model:

Year:

VIN number:

This vehicle is being purchased for use outside of Washington state. The vehicle will be removed from
Washington state by the following means (complete one):
	
	
	

The vehicle will be driven from the seller’s premises under the authority of a trip permit which has
been issued to me by the Washington State Department of Licensing or any agency of another state 		
that has authority to issue similar permits.

	

Trip permit number:

	

	

The vehicle will not be used in Washington state for more than three months and has been licensed in 		
another state. The plates have been attached to the vehicle before it left the seller’s premises.

	

State vehicle is licensed in:

	

License plate number:

Plates are valid until:

Print form
To ask about the availability of this publication in an alternate format for the visually impaired, please call
360-705-6705. Teletype (TTY) users may use the WA Relay Service by calling 711.
REV 27 0002 (5/25/21)				

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Buyer’s Affidavit of In-State Delivery of Motor Vehicles

3 Signature
I, the undersigned buyer, understand that by completing and signing this affidavit I am swearing I am not a
resident of the state of Washington and that I qualify for the tax-exempt purchase of the vehicle described
above. In addition, I understand that false or erroneous use of this affidavit will result in liability for unpaid tax
with interest and result in additional penalties.
Service No. if Member of Armed Service:
Buyer’s signature:

Date:

Name of witness:

Date:

Signature of witness:

REV 27 0002 (5/25/21)				

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