CERTIFICATE OF EXEMPTION
REGARDING SALE OF A MOTOR VEHICLE

The undersigned hereby claims exemption on the purchase of the following described motor vehicle purchased from

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  (NAME OF VENDOR)                                         (VENDORS LICENSE NUMBER)

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  (ADDRESS OF VENDOR - STREET AND CITY)

Year___________  Make ______________ Body Type _____________________

Model _________  Mfg. Serial Number __________________________________

Purchased Price $ ___________________  

And further certifies that this claim is based upon the purchaser's proposed use of the vehicle purchased, the activity of the purchaser, or both, as shown hereon:

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(PURCHASER MUST STATE PRESCRIBED REASON FOR CLAIMING EXEMPTION OR EXCEPTION)

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(PURCHASER'S NAME)                   

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(PURCHASER'S ACTIVITY, I.E. MANUFACTURER
PUBLIC UTILITY, CHURCH, ETC. )

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 (PURCHASER'S ADDRESS - NUMBER AND STREET)

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  (CITY AND STATE)                    

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 (BY - SIGNATURE AND TITLE)           

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(DATE SIGNED)    (VENDOR'S LICENSE, IF ANY)     

Trumbull County Title Dept. Web Form