For purposes of this section, a sale of an automobile truck or bus, or a truck or bus trailer or semitrailer, shall be considered to be a sale of a chassis and of a body enumerated in this paragraph (a)(1).
Percent | |
(i) For articles sold during the period beginning on January 1, 1959, and ending on September 30, 1979 | 10 |
(ii) For articles sold on or after October 1, 1979 | 5 |
__________________________, 19____
Under the penalty of perjury, the undersigned certifies that he, or the ____________________________, (Name of purchaser if other than the undersigned) of which he is __________________ (Title), is in the business of ______________________ (State nature of business), and that the chassis and/or bodies covered by the accompanying order or contract for purchase from ____________________ (Name and address of seller) are purchased for (check One) ____ [] use, or for [] resale for use, as components of the following type or types of nonhighway vehicles:
1. _______________________________
2. _______________________________
3. _______________________________
The undersigned understands that he must be prepared to establish by satisfactory evidence the actual use or disposition of such chassis or bodies and that, upon their use or disposition other than use as components of a nonhighway vehicle, he consents to be treated as the manufacturer of any such chassis or body purchased by him free of the tax imposed by section 4061(a).
The undersigned also understands that he and all guilty parties will, for use of this statement to willfully attempt to evade or defeat the tax imposed under section 4061, be subject, under section 7201, to a fine of not more than $10,000, or imprisonment for not more than 5 years, or both, together with the costs of prosecution.
The undersigned agrees to retain in his possession a copy of this statement for at least 3 years from its date.
_______________________________
(Signature)
_______________________________
(Address)
26 C.F.R. §48.4061(a)-1