1350                                                           STATE OF SOUTH CAROLINA
                                                               DEPARTMENT OF  REVENUE
                              AFFIDAVIT FOR DELIVERY OF TANGIBLE PERSONAL                                                      ST-299
                                                                                                                                 (Rev. 7/30/20)
                              PROPERTY TO THE PURCHASER IN A STATE OTHER                                                                                                       5039
                                                                    THAN SOUTH CAROLINA
                                                                        AFFIDAVIT
STATE OF

COUNTY OF
Personally appeared the below named purchaser, who being duly sworn, deposes and says that the property listed below 
is purchased for use, storage or other consumption outside of South Carolina, that the property will not be returned for 
use, storage or other consumption in South Carolina, and that the purchaser has read and understands the law as printed 
on page two of this form.

Name of purchaser

City and state of delivery

State of residence and 
address of purchaser
                                                               (street)             (city)                      (state)                                                            (ZIP)

Name of seller

Address of seller
                                                               (street)             (city)                      (state)                                                            (ZIP)

Seller's retail license number

Date of sale
                                                               (month)                                         (date)                                                 (year)

DESCRIPTION OF PROPERTY:

Item:

Model:

Serial number:

Purchase price  $                                   Trade-in allowance  $                                    Net amount paid  $

Further deponent sayeth not.

                                                                                             (Purchaser signature)
Sworn to and subscribed before me

this              day of              , year of                    .

     (Notary Public for                                       )
                 VALID ONLY WITH PROOF OF DELIVERY OUTSIDE STATE OF SOUTH CAROLINA
                                                                        SEE PAGE TWO

                          ORIGINAL     Provided for purchaser.                      Copy     Retained by seller.

     50391010
                                                                        1

                             PROOF OF DELIVERY OUTSIDE SOUTH CAROLINA

Place of delivery
                                                       (street)              (city)                                                 (state)                                                                                              (ZIP) 

Date of delivery                                                                       Time of delivery

Means of delivery  (   ) US Mail
                   (   ) Common Carrier (name of carrier)
                                                         Bill of Lading #
                   (   ) Seller or agent of seller (affidavit below must be completed)

                                                                    AFFIDAVIT

STATE OF

COUNTY OF

Personally appeared before me
                                                                         Name of seller/agent of seller
who being duly sworn deposes and says that the tangible personal property described page one was delivered by him

to
                                                                    (Name of purchaser)

at                                                                                                                                on
                                                      .(address)                                         (city)                          (state)                      (ZIP)                                                        (date)

Further deponent sayeth not.

                                                                                                       Signature of person making delivery

Sworn to and subscribed before me

this              day of              , year of                    .

Notary Public for State of

(Section 12-36-2520.) If the seller delivers tangible personal property to the purchaser in a state other than South 
Carolina and receives from the purchaser a statement, given under oath, that the property was purchased for storage,use, 
or consumption outside of South Carolina and that the property will not be returned for storage, use or consumption in 
South Carolina, the sales or use tax due on the transactions will be transferred to the purchaser if the statement contains 
a description of the property, the date of sale, the amount of the purchase price, and the city and state of delivery. The 
statement must be retained by the seller and upon request forwarded to the department. The department may forward a 
copy of the statement to the taxing authority of the state of delivery. If the property is subsequently stored,used, or 
consumed in this State, the purchaser, in addition to the sales or use tax, shall pay a penalty in an amount equal to fifty 
percent of the tax.

  50392018
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