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MVR-60B (5/92)
GROSS RECEIPTDECLARATION
FOR LEASED
OR RENTAL VEHICLES
This is to certify that I purchased a
(YEAR) (MAKE)
for lease or rental purposes.
(VEHICLE IDENTIACATION NUMBER)
0 I elect to pay a tax on the gross receipts of the lease or rental of the vehicle
directly to the North Carolina Department of Revenue under Sales and Use Tax
registration number
0 I will be leasing this- vehicle to the person listed below who will re-lease it and
pay tax on the gross receipts of the lease or rental of the vehicle directly to the
N.C. Department of Revenue under Sales and Use Tax registration number
Our firm's Sales and Use Tax registration number is
(NAME OF OWNER)
(SIGNATURf:pF OWNER)
(STREET ADDRESS)
(CITY) (STATE) (ZIP CODE)
(NAME OF LESSEE)
(STREET ADDRESS)
(CITY) (STATE) (ZIP CODE)


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