Form 5000 - Transaction Privilege Tax Exemption Certificate
Download a blank fillable Form 5000 - Transaction Privilege Tax Exemption Certificate in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 5000 - Transaction Privilege Tax Exemption Certificate with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Arizona Department of Revenue
ARIZONA FORM
5000
Transaction Privilege Tax Exemption Certifi cate
This form replaces earlier
forms: 5000, 5001, 5002.
This exemption Certifi cate is prescribed by the Department of Revenue pursuant to ARS § 42-5009. The purpose of the certifi cate is to document
tax-exempt transactions with qualifi ed purchasers. It is to be fi lled out completely by the purchaser and furnished to the vendor. The vendor shall
retain this Certifi cate for single transactions or for specifi ed periods as indicated below. Incomplete Certifi cates are not considered to be accepted
in good faith. Only one form of exemption can be claimed on a certifi cate.
Purchaser’s Name and Address
Check Applicable Box:
Single Transaction Certifi cate
Period From:
Through:
Vendor’s Name
(You must choose specifi c dates for which certifi cate will be valid)
Choose one transaction type per Certifi cate
Transactions with a Business
Transactions with Native
Transactions with
Americans & Native American
nonresidents
(Please check appropriate item from numbers 1 - 19)
Businesses
(Please check appropriate item
Arizona Transaction Privilege Tax License Number
(Please check item number 24 or 24a)
from numbers 25 - 26)
SSN / EIN
Tribal Business License #
State of residence
OR
Other Tax License Number
Tribal ID#
Driver’s License#
Name of Tribe
Tax number for another tax agency
Driver’s License
State
If no license number, provide reason:
Transactions with a
SSN/ID
Government entity or certain
Health Care Institutions
Precise Nature of Purchaser’s Business
30 day Drive
(Please check appropriate item
out permit #
from numbers 1 - 23)
Reason for Exemption - check as applicable
1. Tangible personal property to be resold in the ordinary course of business.
2. Tangible personal property to be leased or rented in the ordinary course of business.
3. Tangible personal property to be incorporated into a taxable contracting project.
4. Food, drink, or condiments purchased by a restaurant business.
5. Motor vehicle fuel and use fuel subject to tax under ARS § 28-5606 or 5708.
6. Use fuel to a holder of a valid single trip use fuel tax permit issued under ARS § 28-5739.
7. Aviation fuel subject to the tax imposed under ARS § 28-8344.
8. Pipes or valves four inches in diameter or greater to be used for transportation of oil, natural gas, artifi cial gas, water or coal slurry.
9. Neat animals, horses, asses, sheep, ratites, swine or goats used as breeding or production stock (including ownership shares in such animals).
10. Aircraft, navigational and communication instruments and related accessories sold or leased to:
Airlines holding a federal certifi cate of public convenience and necessity; or
Airlines holding a foreign air carrier permit for air transportation; or
Any foreign government or nonresidents of Arizona who will not use such property in Arizona other than in removing such property from this state.
11. Railroad rolling stock, rails, ties and signal control equipment used directly to transport persons or property for hire.
12. Buses or urban mass transit vehicles used directly to transport persons or property for hire or pursuant to a government mass transit program.
13. Central offi ce switching equipment, switchboards, private branch exchange equipment, microwave radio equipment and carrier.
Equipment including optical fi ber, coaxial cable and other transmission media which are components of carrier systems sold or leased to
persons engaged in the telecommunications business.
14. New machinery and equipment, used for commercial production of agricultural, horticultural, viticultural and fl oricultural crops and
products in this state, consisting of tractors, tractor-drawn implements, self-powered implements, drip irrigation lines, and machinery
and equipment necessary for extracting milk and for cooling milk and livestock.
15. Machinery, equipment or transmission lines used directly in producing or transmitting electrical power, but not including distribution.
(OVER)
ADOR 60-2010 (12/04)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial