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OR DIPLOMATIC EXEMPTION FROM TAXES ON GASOLINE COUNTRY TYPE OF ACCOUNT Personal Mission LOCATION (City) NAME - OFFICE* OR INDIVIDUAL (Last, First and MI) * For Offices, please also include a contact person DATE OF BIRTH (mm-dd-yyyy) VEHICLE TAG NUMBERS #1 #2 #3 OIL COMPANY #4 OIL COMPANY ACCOUNT NUMBER FOR OFFICE USE ONLY EMBASSY CONSULATE (Formerly DSP-99A) DS-99 12-2002 UN OAS R OTHER Page 1 of 2 THIS APPLICATION IS NOT VALID FOR SALES TAX EXEMPTION U.S. Department of State.

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