THIS IS TO CERTIFY that I am Entitled to an Ad Valorem Tax Credit for Month(s) on the Motor Vehicle
Described Below. Which was Registered on and Ad Valorem Tax paid Through  
I Hereby Certify that the Motor Vehicle was Sold on

OR

(1) Motor Vehicle was Totally Destroyed on (2) Motor Vehicle was Stolen Without Recovery on (3) Motor Vehicle was Traded on (4) Motor Vehicle was Permanently Removed  form the State of Alabama on Tag # Decal # Expiration Date:    Make - Model - Year and VIN are required to complete this form Make Model   Year   VIN