2017 0419 Tax Commission Application Vehicle Registration
Application For: Osage Nation Certificate of Motor Vehicle Registration Body Type
Model Yr. Vehicle Identification Number
Factory Delivery Price
Make
Class
Date Issued
Model
Registration Expires
Prev. Reg: Tag No.
Title Number
Unladen Wt.
Decal Number
Personal
Yrs. Reg.
Tax Exempt
Load Carried
Personal Decal
Carrying Capacity
Tax Penalty
Total
Name: I hereby certify that according to the records of the Osage Nation Tax Commission, the person named above is the owner of the vehicle described and that all taxes and fees upon such vehicle have been duly paid for the period and in the amount indicated .
By: ________________________________________ Osage Nation Tax Commission
I, the undersigned, hereby make application or registration of the vehicle described above and do solemnly swear or affirm that I am a member of the Osage Nation and owner or the legal agent of the owner of this vehicle and that the statements contained herein are true and that the vehicle described herein complies with the Motor Vehicle Registration and Taxation Laws of the Osage Nation. I swear or affirm that I am a resident of and principally garage this vehicle within Osage Nation jurisdiction. This certificate and your title must be presented to obtain a new registration. This certificate and your title must be surrendered to the purchaser of this vehicle. Owner or Legal Agent: ____________________________________________ Date: _____________________________ Subscribed and sworn to before me this__________day of_________________________, 20___________ My Commission Expires: __________________________________________________________________ Notary Public: ___________________________________________________________________________ (Seal) Copy of Tax Registration must be carried in vehicle. This certificate and your title must be presented when applying for new registration. Osage Nation Tax Commission * 627 Grandview Ave * Pawhuska, Oklahoma 74056 Received Form:
Date:
Including: *Reg. (Tax & Penalty)
*Interest
*Notary
*Personal
*Title
*Lien Fees
*Other
*Excise Tax
Covering Fees, Charges and Taxes levied under Osage Nation Motor Vehicle Taxation & Registration Law on the current model Vehicle Date Title Assigned:
Factory Delivered Price:
Decal No.
Check No.
Osage Nation Tax Commission By: Osage Nation Tax Commission Authorized Agent
Model Yr. Vehicle Identification Number
Factory Delivery Price
Make
Class
Date Issued
Model
Registration Expires
Prev. Reg: Tag No.
Title Number
Unladen Wt.
Decal Number
Personal
Yrs. Reg.
Tax Exempt
Load Carried
Personal Decal
Carrying Capacity
Tax Penalty
Total
Name: I hereby certify that according to the records of the Osage Nation Tax Commission, the person named above is the owner of the vehicle described and that all taxes and fees upon such vehicle have been duly paid for the period and in the amount indicated .
By: ________________________________________ Osage Nation Tax Commission
I, the undersigned, hereby make application or registration of the vehicle described above and do solemnly swear or affirm that I am a member of the Osage Nation and owner or the legal agent of the owner of this vehicle and that the statements contained herein are true and that the vehicle described herein complies with the Motor Vehicle Registration and Taxation Laws of the Osage Nation. I swear or affirm that I am a resident of and principally garage this vehicle within Osage Nation jurisdiction. This certificate and your title must be presented to obtain a new registration. This certificate and your title must be surrendered to the purchaser of this vehicle. Owner or Legal Agent: ____________________________________________ Date: _____________________________ Subscribed and sworn to before me this__________day of_________________________, 20___________ My Commission Expires: __________________________________________________________________ Notary Public: ___________________________________________________________________________ (Seal) Copy of Tax Registration must be carried in vehicle. This certificate and your title must be presented when applying for new registration. Osage Nation Tax Commission * 627 Grandview Ave * Pawhuska, Oklahoma 74056 Received Form:
Date:
Including: *Reg. (Tax & Penalty)
*Interest
*Notary
*Personal
*Title
*Lien Fees
*Other
*Excise Tax
Covering Fees, Charges and Taxes levied under Osage Nation Motor Vehicle Taxation & Registration Law on the current model Vehicle Date Title Assigned:
Factory Delivered Price:
Decal No.
Check No.
Osage Nation Tax Commission By: Osage Nation Tax Commission Authorized Agent
