Excise Tax gift Exemption Form

GOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF MOTOR VEHICLES EXCISE TAX GIFT EXEMPTION FORM This application is for the transfer of ownership between qualified relatives with an existing District of Columbia Title ONLY DC TITLE NUMBER VEHICLE MAKE/MODEL VEHICLE IDENTIFICATION NUMBER VEHICLE YEAR PREVIOUS OWNER'S INFORMATION LAST NAME FIRST NAME MIDDLE NAME DOB NEW OWNER'S INFORMATION LAST NAME FIRST NAME MIDDLE NAME DOB RELATIONSHIP Gift Excise Tax Exemption ONLY applies to one of the following relationships listed below: (Proof of relationship required) PARENT TO CHILD* SPOUSE** Special Requirements: CHILD TO PARENT* DOMESTIC PARTNER*** * Must present an original full birth certificate or adoption court order reflecting both the child's and parent's names ** Must present an original marriage license *** Must present a certified copy of a domestic partnership certificate We certify the above information is true and correct to the best of our knowledge, information and belief. The making of a false statement on this form is a violation of DC law and is subject to a fine of up to a $1000 or 180 days imprisonment or both (DC Official Code § 22-2405). _______________ Date ____________________________ Signature of Primary Prior Owner _______________________________ Signature of Co- Owner (if applicable) _______________ Date ____________________________ Signature of Primary New Owner _______________________________ Signature of Co- Owner (if applicable) If you have questions, please visit our website, www.dmv.dc.gov, or call 311 in DC or 202-737-4404 outside the 202 area code. To confidentially report waste, fraud or abuse by any DC Government Agency or official, call the DC Inspector General at 1-800-521-1639 American LegalNet, Inc. www.FormsWorkFlow.com DMV-EGTE-01Rev. 7/15