Form St-124: (5/06): Certificate Of Capital Improvement
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2ST-124
New York State and Local Sales and Use Tax
(5/06)
Certificate of Capital Improvement
After this certificate is completed and signed by both the customer and the contractor
performing the capital improvement, it must be kept by the contractor.
Read this form completely before making any entries.
This certificate may not be used to purchase building materials.
Name of customer
Name of contractor
(print or type)
(print or type)
Street address
Street address
City
State
ZIP code
City
State
ZIP code
Certificate of Authority number (if any)
Certificate of Authority number (if any)
To be completed by the customer:
Describe capital improvement to be performed:
Project name
Street address (where the work is to be performed
City
State
ZIP code
I certify that:
tenant, of the real property identified on this form, and
— I am the
owner,
— The work described above will result in a capital improvement to the real property within the guidelines of this form, and
— This contract
includes,
does not include, the sale of tangible personal property that, when installed, retains its
(check one)
identity as tangible personal property and does not become a permanent part of the real property.
I understand that:
— I will be responsible for any sales tax, interest, and penalty due on the contractor’s total charge for tangible personal property and for
labor, if it is determined that this work does not qualify as a capital improvement, and
— I will be required to pay the contractor the appropriate sales tax on tangible personal property (and any associated services)
transferred to me pursuant to this contract, when the property installed by the contractor does not become a permanent part of the
real property; and
— I will be subject to civil or criminal penalties (or both) under the Tax Law, if I issue a false or fraudulent certificate.
Signature of customer
Title
Date
To be completed by the contractor:
I, the contractor, certify that I have entered into a contract to perform the work described by the customer named above. (A copy of the
written contract, if any, is attached.)
I understand that my failure to collect tax as a result of accepting an improperly completed certificate will make me personally liable for
the tax otherwise due, plus penalties and interest.
Signature of contractor or officer
Title
Date
This certificate is not valid unless all entries are completed.
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