Application for the Tribal Member Exemption From the Motor Vehicle

SD EForm - 2386
V2
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State of South Dakota
Division of Motor Vehicles
445 E. Capitol Avenue
Pierre, SD 57501
605-773-3541 | http://dor.sd.gov/Motor_Vehicles/
VALIDATION AND
OFFICE USE ONLY
Application for the Tribal Member Exemption From the Motor Vehicle Excise Tax
Please submit completed application form along with copies of your tribal identification card, your driver license (if available)
and title application paperwork to your local county treasurer’s office. Office locations and mailing addresses for county
treasurers can be found at http://dor.sd.gov/Motor_Vehicles/.
Applicant(s) Name(s) ___________________________________________________________________
A
Applicant
and Vehicle
Information
Mailing Address: _______________________________________________________________________
Daytime Phone: __________________ E-mail Address: ________________________________________
Vehicle Title Number____________________________________
Vehicle Identification Number (VIN)_________________________________________
To be exempt from South Dakota’s motor vehicle excise tax imposed by
SDCL 32-5B-1, at the time the vehicle is purchased the applicant must:
B
Exemption
Information
(1) be an enrolled member of a federally recognized Indian tribe; AND
(2) reside on Indian country (as defined by 18 U.S.C. § 1151) in
South Dakota that is governed by the tribe in which you are a
member.
Tax Exemption Code: ____________
C
Exemption
Qualifying
Information
Tribe
Cheyenne River Sioux Tribe
Crow Creek Sioux Tribe
Flandreau Sioux Tribe
Lower Brule Sioux Tribe
Oglala Sioux Tribe
Rosebud Sioux Tribe
Sisseton Wahpeton Sioux Tribe
Standing Rock Sioux Tribe
Yankton Sioux Tribe
20
23
24
25
26
21
28
22
29
1) Are you an enrolled member of a federally recognized Indian tribe?
Yes
No
If “Yes”, please identify: _________________________________________________________
Tribe
Enrollment Number
2) At the time you purchased the vehicle, in which county did you actually live?
3) What was your physical address at the time you purchased the vehicle? (No PO Box numbers)
__________________________________________________________________________________
4) What was the legal description of where you resided at the time you purchased the vehicle?
(Only required for the following counties: Moody, Bennett, Mellette, Tripp, Gregory, and Charles Mix)
Please contact your county treasurer if you need assistance.
D
Documentation
Please attach copies of:
Tribal Identification Card
Driver's License
I declare and affirm under the penalties of law that the information I have provided on this
application is in all things true and accurate.
E
Applicant
Signature
08/2014
_____________________________________________________ _____________________________
Applicant’s Signature
Date
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