Free Applicant Name - Kansas


File Size: 17.0 kB
Pages: 1
Date: June 27, 2008
File Format: PDF
State: Kansas
Category: Tax Forms
Author: Kathleen A Shea
Word Count: 236 Words, 2,039 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.kansas.gov/cota/documents/TXAdd-vehicle.pdf

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Addition to Exemption Vehicles Page 1 of 1

Applicant Name: _______________________ Docket No.: ___________________________

Addition to Exemption Application Vehicles
1. Provide a copy of the title(s) to the subject vehicle(s).
(Note: Effective January 1, 2003, titles for vehicles subject to liens or security interests are held in electronic format by the Kansas Department of Revenue, Division of Vehicles. If this affects your vehicle and you cannot provide a copy of a paper title, please provide a copy of another document showing the date you acquired the subject vehicle, such as your first registration receipt showing a "Purch/To KS" date or a dated bill of sale.)

2.

Where is/are the vehicle(s) housed when not in use? ______________________________________________________________________________

3.

If the vehicle(s) is/are kept at an individual's home, please explain why. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

4. 5.

What percentage of the time is/are the vehicle(s) used for personal use?_____________________ Do the operators of the vehicle(s) own personal vehicles that they drive to and from work? _____Yes _____No Is/are the vehicle(s) considered in any way to be compensation for salary? _____Yes _____No VERIFICATION

6.

I, ________________________________, do solemnly swear or affirm that the information set forth herein is true and correct, to the best of my knowledge and belief. So help me God. _______________________________________ Signature of Applicant _______________________________________ Printed Name and Title State of ______________________ County of ____________________ This instrument was acknowledged before me on _________ by ________________________________.

Seal My appointment expires: ________________
Revised 5/07

______________________________________ Signature of Notary Public