Tennessee Department Of Revenue - State Of Tennessee
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TENNESSEE DEPARTMENT OF REVENUE
Application for the Agricultural
Sales and Use Tax Exemption
1. Entity Name
FEIN/SSN/SOS#
___________________________
2. Mailing Address
Street
City
State
ZIP Code
3. Entity Phone No.
Email Address
4. Farm Location
Street
City
County
5. Entity Contact
Name
Phone Number (Required)
Email Address
☐
☐
☐
6. Type of entity:
Farmer
Timber Harvester
Nursery Operator
7. Type of ownership:
☐
☐
☐
a.
Partnership
d.
Sole Proprietorship
f.
Marital Joint Ownership
(must provide SSN for joint owners)
☐
☐
☐
b.
Professional LLC
e.
Limited Partnership
g.
Limited Liability Company
☐
☐
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c.
S Corporation
f.
Other Professional Corporation
i.
Corporation
8. Applicant must meet at least one of the following criteria to receive the agricultural exemption. Check all that
apply. You must submit proper documentation with application (see instructions).
☐
a.
The owner or lessee of agricultural land from which $1,000 or more of agricultural products were
produced and sold during the year, including payments from government sources.
☐
b.
In the business of providing for-hire custom agricultural services for the plowing, planting, harvesting,
growing, raising, or processing of agricultural products or for the maintenance of agricultural land.
☐
c.
The owner of land that qualifies for taxation under the provisions of the Agricultural Forest and Open
Space Land Act of 1976 (Tenn. Code Ann. § 67-5-1001 et seq.).
☐
d.
Have a federal income tax return that contains one or more of the following:
☐
i.
Business activity on IRS Schedule F (Profit or Loss from Farming)
☐
ii.
Farm rental activity on IRS Form 4835 (Farm Rental Income and Expenses) or Schedule E
(Supplemental Income and Loss)
☐
e.
Otherwise establish to the satisfaction of the Commissioner of Revenue that you are actively engaged
in the business of raising, harvesting, or otherwise producing agricultural commodities as defined in Tenn.
Code Ann. § 67-6-301(c)(2).
Affidavit of Applicant
Under penalties of perjury, I declare that to the best of my knowledge this information is true and correct. I understand that any
authority given as a result of this application is limited to purchases of the agricultural items specifically listed under Tenn. Code
Ann. § 67-6-207 that will be used in producing agricultural products, including nursery products, or used for harvesting timber.
The use of this authority for purposes other than those authorized by law may result in the assessment of additional taxes,
penalties, and interest.
Print Name
Title
Signature
Date
Please mail application and attachments to:
Tennessee Department of Revenue
Taxpayer Services Division
500 Deaderick Street
Nashville, TN 37242
RV-F1308401 (2-17)
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