REGULATIONS - PRIVILEGE AND EXCISE TAXES
Reg. ___-360.2. Proof of exemption: exemption certificate.
For the purpose of proof of exemption, in transactions other than those in which the proof is set by standard documentation as detailed in Regulations ___-350.1 and ___-360.1, the minimum acceptable proof and documentation for each transaction shall be the completion, at the time of the transaction, in all material respects, of a certificate containing all the information set forth below. For the purpose of validating the vendor's claim of exemption, such certificate is sufficient if executed by any person with apparent authority to act for the customer, and the information provided validates the claim.
INVALID UNLESS COMPLETED IN FULL
VENDOR'S NAME ___________________________________
Sales Invoice No. ________
Customer's Exemption Claim
City of ____________________ Privilege License (Sales) Tax
Customer's Business Name: __________________________________________________
Customer's Business Address: __________________________________________________
Specific Business Activity: __________________________________________________
(e.g., if retailer, lessor, or
manufacturer, specify items __________________________________________________
leased, sold or made, i.e.,
cars, computers, clothes, etc.) __________________________________________________
Customer's License
Nos. _________ City: ______________________
State: _________
ITEMS CLAIMED AS EXEMPT FROM TAX
____________________: All Items on This Invoice or Purchase Order.
or
____________________: Only Those Items Marked With an "E".
REASON FOR CLAIMED EXEMPTION:
____________________: The items claimed as exempt are sold, rented, leased, or licensed by the above named customer in the normal course of its business activity.
or
____________________: The items claimed as exempt are exempt from the City of __________________________ Privilege Tax for the following specific reason(s):
CUSTOMER'S CERTIFICATE
I certify that the above information is accurate to the best of my information and belief, and that I am authorized by the Customer above to acquire the items claimed as exempt on a tax-free basis on its behalf. I further understand that the making of a false or fraudulent claim to obtain a tax exemption is a Class One **(Model Option #14A: Class Two)** **(Model Option #14B: Petty Offense)** Misdemeanor under City Code Section ___-580.
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Name
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Date
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Title