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RPC016052_EN_WB_L_1

VRT - Vehicle Purchase Details Form


Persons other than authorised traders VRTVPD2
• This form must be completed by the purchaser in respect of the vehicle being presented for registration at an NCTS Centre.
• The presented vehicle will not be registered unless this form is completed fully.
• An Invoice / Declaration of Sale from the vehicle seller must accompany this form.
• Please use BLOCK LETTERS only when completing this form.

1 Vehicle Details: Foreign Registration No.:

VIN / Chassis No.:

Make: Version:

Model:

2 Person / Business From Whom The Vehicle Was Purchased:


Type of Seller (please tick one): Motor Dealer: Auction House: Other Business: Private Individual:

Name / Business Name:

Address:

Contact Number: VAT Number (if applicable):

Email Address (if available): Website (if available):


3 If the vehicle was purchased abroad and imported into the State by a third party please enter their details here:

Name:

Address (include Eircode):

Contact Number:
Revenue Customer No.:
Email Address (if available):
(PPSN / VAT)
4 Vehicle Purchase Details:
Purchase Price (incl. VAT): CUR Date of Sale / Purchase: D D M M Y Y Y Y

VAT Amount * (if applicable): CUR Date of Entry into the State: D D M M Y Y Y Y

* If the vehicle was not purchased from a Private Individual, please provide VAT amount details.

Declaration
If you are in doubt about any part of this declaration you should contact Revenue.

I, the undersigned, declare that I purchased the vehicle detailed above, and that the information contained on this form and in the
supporting documents is correct.

Signature:

Name (Block Letters):


Date: PPSN /
D D M M Y Y Y Y
Revenue Customer No.:
It is an offence to make a false declaration. A false declaration will result in steps to recover
tax and may result in financial penalties (min. €5,000) and / or prosecution.
This document will be scanned by the NCTS upon receipt and the original will be forwarded to the Revenue Commissioners.
The Revenue Commissioners collect taxes and duties and implement customs controls. Revenue requires customers to provide certain
personal data for these purposes and certain other statutory functions as assigned by the Oireachtas. Your personal data may be
exchanged with other Government Departments and agencies in certain circumstances where this is provided for by law. Full details of
Revenue’s data protection policy setting out how we will use your personal data as well as information regarding your rights as a data
subject are available on our Privacy page on www.revenue.ie. Details of this policy are also available in hard copy upon request.
Designed by the Revenue Printing Centre

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