Form ST-A-107 "Affidavit of Exemption (Out-of-State Delivery)" - Maine

What Is Form ST-A-107?

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 June 1, 1984;
  • 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-107 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-107 "Affidavit of Exemption (Out-of-State Delivery)" - Maine

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MAINE REVENUE SERVICES
SALES/EXCISE TAX DIVISION
AFFIDAVIT OF EXEMPTION
(To support out-of-state delivery)
The undersigned hereby certifies that the item described below is sold exempt from Maine sales tax because
it was delivered to the purchaser outside the State of Maine by contract or common carrier or by the seller.
Type of Property ______________________________________________________________________________
mobile home, motor vehicle, boat, etc.
Make____________________________ Year__________________ Model No. ____________________________
Serial No.___________________ Sales Price $______________________ Trade in $________________________
Date of Sale______________________________ Date of Delivery_______________________________________
The property described above was delivered to: Name of Purchaser_______________________________________
Legal Address of Purchaser______________________________________________________________________
Street
City
State
Place of Delivery * ____________________________________________________________________________
Street
City
State
I hereby authorize Maine Revenue Services to furnish a copy of this affidavit to the state in which the purchaser de-
clares herein as his legal address and/or to the state in which delivery was made.
Name of Seller_____________________________________ Sales Tax Cert. No.___________________________
Address______________________________________________________________________________________
Signature of Seller _____________________________________________________________________________
Signature of Person Making Delivery ______________________________________________________________
The person shown above as seller or making delivery _________________________________________________
Name of person
personally came to me, who being duly sworn, did depose and say that the statements contained herein are true and
correct.
Signed:______________________________________
_________________________________________
Justice of the Peace-Notary Public
Date: ______________________________________
My commission expires:_______________________
INSTRUCTIONS: This form, when completed, is to be forwarded by the dealer to the Sales Tax Section with the dealer's monthly sales tax report on which this sale is claimed to be exempt.
*If delivery was by common or contract carrier employed by dealer, or was delivered directly form the factory to a point outside Maine by someone other than the dealer, please explain manner of
delivery, giving name and address of delivery carrier, on back of this sheet. In such cases the dealer should retain in his files documentary evidence of such delivery.
ST-A-107
Rev. 6/84
MAINE REVENUE SERVICES
SALES/EXCISE TAX DIVISION
AFFIDAVIT OF EXEMPTION
(To support out-of-state delivery)
The undersigned hereby certifies that the item described below is sold exempt from Maine sales tax because
it was delivered to the purchaser outside the State of Maine by contract or common carrier or by the seller.
Type of Property ______________________________________________________________________________
mobile home, motor vehicle, boat, etc.
Make____________________________ Year__________________ Model No. ____________________________
Serial No.___________________ Sales Price $______________________ Trade in $________________________
Date of Sale______________________________ Date of Delivery_______________________________________
The property described above was delivered to: Name of Purchaser_______________________________________
Legal Address of Purchaser______________________________________________________________________
Street
City
State
Place of Delivery * ____________________________________________________________________________
Street
City
State
I hereby authorize Maine Revenue Services to furnish a copy of this affidavit to the state in which the purchaser de-
clares herein as his legal address and/or to the state in which delivery was made.
Name of Seller_____________________________________ Sales Tax Cert. No.___________________________
Address______________________________________________________________________________________
Signature of Seller _____________________________________________________________________________
Signature of Person Making Delivery ______________________________________________________________
The person shown above as seller or making delivery _________________________________________________
Name of person
personally came to me, who being duly sworn, did depose and say that the statements contained herein are true and
correct.
Signed:______________________________________
_________________________________________
Justice of the Peace-Notary Public
Date: ______________________________________
My commission expires:_______________________
INSTRUCTIONS: This form, when completed, is to be forwarded by the dealer to the Sales Tax Section with the dealer's monthly sales tax report on which this sale is claimed to be exempt.
*If delivery was by common or contract carrier employed by dealer, or was delivered directly form the factory to a point outside Maine by someone other than the dealer, please explain manner of
delivery, giving name and address of delivery carrier, on back of this sheet. In such cases the dealer should retain in his files documentary evidence of such delivery.
ST-A-107
Rev. 6/84