Affidavit in Support of a Claim for Exemption from Sales or Use Tax for a Motor Vehicle Transferred Within a Family
The purchaser of a motor vehicle acquired for use, storage or
other consumption in the Commonwealth of Massachusetts is
required to pay a sales or use tax unless an exemption is specifi-
cally provided for in the Massachusetts General Laws or the
Code of Massachusetts Regulations.
An exemption from the sales or use tax for the transfer of a motor
vehicle within a family under specified conditions is provided for
by the Massachusetts regulations and statutes. In order to be
exempt from the sales and use tax, you must meet the require-
ments of the law and complete the affidavit above. You must fill
in all blanks and print or type your entries, except at the end of
the affidavit where your signatures are required.
Affidavit in Support of a Claim for
Exemption from Sales or Use Tax for
a Motor Vehicle Transferred Within a Family
Please read the instructions below before completing this form and provide the following information.
All entries must be printed or typed except for signatures.
This claim for exemption is based on a transfer of a motor vehicle between certain family members.
Motor Vehicle Transferred
Year Make Model Vehicle identification number Title number
The above-described vehicle was transferred from , of
of on .
The above-described vehicle was transferred from (check one): Spouse Son Daughter Mother Father Sister Brother
I declare under the pains and penalties of perjury that I have reviewed this affidavit and the statements I have made in it and declare that they
Signature of prior owner(s) Date
Signature of new owner Date
If the prior and new owner(s) reside at the same address or have the same last name, only the new owner(s) need sign this affidavit.
Please note that your statements are to be made under the pains
and penalties of perjury and that a statement which is made will-
fully and is false as to a material matter may be punished as a
felony under Massachusetts General Laws, Chapter 62C, sec-
tion 73, or Chapter 268, section 1A. Perjury is a serious crime
and punishment can be severe.
If you have any questions about the acceptance or use of this affi-
davit, please contact: Massachusetts Department of Revenue,
Customer Service Bureau, PO Box 7010, Boston, MA 02204,
This form is approved by the Commissioner of Revenue and may be reproduced.
City/Town State Zip
Address City/Town State Zip Date
Affidavit in Support of a Claim for Exemption from Sales or Use Tax for a Motor Vehicle Transferred Within a Family PDF
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