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Certificate of Non-Assessment (Tax Waiver) Request Form

2. Select one:*

   1. This is my first vehicle or other personal property owned.
   2. I have not owned a vehicle or other personal property for more than a year.
   3. I moved to Missouri from another state or country, and own personal property.
   4. I have a leased vehicle.
4. Select one:*

   1. I am the lessee.
   2. I am the lessor (leasing company or dealer).
6. Lessor Name (Leasing Company)*

   Please complete the remainder of the form with the lessee's information.

8. Lessor Name (Leasing Company)*
10. First Name*
11. Middle Initial*

    Enter "NONE" if not applicable.

12. Last Name*
14. Lessor Email Address*
16. Email Address*
17. Phone Number*
19. Lessee First Name*
20. Lessee Middle Initial*

    Enter "NONE" if not applicable.

21. Lessee Last Name*
23. Is there a co-owner listed on the title?*

    1. Yes
    2. No
25. Which state/country did you move to St. Charles County from?*
27. Date you moved to Missouri:*
29. Co-Owner First Name*
30. Co-Owner Middle Initial
31. Co-Owner Last Name*
33. Co-Owner Address*
35. Co-Owner Address City*
36. Co-Owner Address State*
37. Co-Owner Address Zip*
39. Do you want the co-owner listed on your personal property account?*

    1. Yes
    2. No
41. Which year was your vehicle purchased?*

    1. 2021
    2. 2020
    3. 2019
43. Address on Your Move-In Date*
45. City*
46. State*
47. Zip*
49. Address on Jan. 1 of year purchased*
    For example: If you purchased the vehicle in 2020, this is your address as of Jan. 1, 2020.
51. City*
52. State*
53. Zip*
55. Address on Jan. 1 of year leased*

    For example: If the vehicle was leased in 2020, this is the address as of Jan. 1, 2020.

57. City*
58. State*
59. Zip*
61. Current Address*

    1. Same as above
    2. Different than above
63. Current Address*

    1. Same as above
    2. Different than above
65. Current Address*
67. City*
68. State*
69. Zip*
71. Is there a co-lessee listed on the lease agreement?*

    1. Yes
    2. No
73. Co-Lessee First Name*
74. Co-Lessee Middle Initial
75. Co-Lessee Last Name*
77. Which year did the leasing agreement begin for the vehicle?*

    1. 2021
    2. 2020
    3. 2019
79. Date Moved to Current Address*
81. Have you lived in Missouri before?*

    1. Yes
    2. No
82. Which county(s) in Missouri have you lived in?*
84. Document Upload*

    Please upload a PDF, JPG or PNG of one of the following documents: title (front and back; seller and purchaser information must be completed), title application, Missouri vehicle registration renewal notice, current out-of-state registration, or bill of sale.

86. Document Upload*

    Please upload a PDF, JPG or PNG of one of the following documents: lease agreement, Missouri vehicle registration renewal notice, title application, or current out-of-state registration.

88. Additional Document Upload (If Needed)
Leave This Blank:


90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit

* indicates a required field