Form ST-A-101 "Affidavit Regarding Lease of Automobile for Service Customer" - Maine

What Is Form ST-A-101?

This is a legal form that was released by the Maine Department of Administrative and Financial Services - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2011;
  • The latest edition provided by the Maine Department of Administrative and Financial Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form ST-A-101 by clicking the link below or browse more documents and templates provided by the Maine Department of Administrative and Financial Services.

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Download Form ST-A-101 "Affidavit Regarding Lease of Automobile for Service Customer" - Maine

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MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
AFFIDAVIT REGARDING LEASE OF AUTOMOBILE FOR SERVICE CUSTOMER
Individual Certificate
I hereby certify that the undersigned new vehicle dealer (“Dealer”) holds a valid
Retailer’s Registration Certificate, No. _________, issued pursuant to the Maine
Sales
and
Use
Tax
Law,
and
that
the
short-term
rental
from
_________________________described below is to one of our service customers
pursuant to a manufacturer’s or new vehicle dealer’s warranty.
Rental agreement #
________________
Rental agreement date
________________
Lessee Name
______________________
Service Order #
________________
Blanket Certificate
I hereby certify that the undersigned new vehicle dealer (“Dealer”) holds a valid
Retailer’s Registration Certificate, No. _________, issued pursuant to the Maine
Sales
and
Use
Tax
Law,
and
that
all
short-term
rentals
from
_____________________ will be for our service customers pursuant to a
manufacturer’s or new vehicle dealer’s warranty.
I further certify that the rental fee in either case will be paid by the Dealer. I
understand that the Dealer may be liable for payment to the State of Maine of any
rental tax, together with interest and penalties, if the above mentioned rental(s)
ultimately does not meet the requirements of the sales tax exemption found in 36
MRSA §1760, sub-§92.
_________________________________
_______________________________________
NAME OF DEALER
DATE
_________________________________
_______________________________________
SIGNATURE
PRINTED NAME AND TITLE
ST-A-101
10/01/11
MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
AFFIDAVIT REGARDING LEASE OF AUTOMOBILE FOR SERVICE CUSTOMER
Individual Certificate
I hereby certify that the undersigned new vehicle dealer (“Dealer”) holds a valid
Retailer’s Registration Certificate, No. _________, issued pursuant to the Maine
Sales
and
Use
Tax
Law,
and
that
the
short-term
rental
from
_________________________described below is to one of our service customers
pursuant to a manufacturer’s or new vehicle dealer’s warranty.
Rental agreement #
________________
Rental agreement date
________________
Lessee Name
______________________
Service Order #
________________
Blanket Certificate
I hereby certify that the undersigned new vehicle dealer (“Dealer”) holds a valid
Retailer’s Registration Certificate, No. _________, issued pursuant to the Maine
Sales
and
Use
Tax
Law,
and
that
all
short-term
rentals
from
_____________________ will be for our service customers pursuant to a
manufacturer’s or new vehicle dealer’s warranty.
I further certify that the rental fee in either case will be paid by the Dealer. I
understand that the Dealer may be liable for payment to the State of Maine of any
rental tax, together with interest and penalties, if the above mentioned rental(s)
ultimately does not meet the requirements of the sales tax exemption found in 36
MRSA §1760, sub-§92.
_________________________________
_______________________________________
NAME OF DEALER
DATE
_________________________________
_______________________________________
SIGNATURE
PRINTED NAME AND TITLE
ST-A-101
10/01/11