Cert-124 1/05 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Water Pollution Control Facilities 2005 Page 2
Download a blank fillable Cert-124 1/05 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Water Pollution Control Facilities 2005 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 Cert-124 1/05 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Water Pollution Control Facilities 2005 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
2reset
Name of Purchaser
Address
CT Tax Registration Number
Federal Employer ID Number
(If none, explain)
Name of Seller
Address
CT Tax Registration Number
Federal Employer ID Number
(If none, explain)
Check One Box:
Blanket Certificate
Certificate for One Purchase Only
Check Applicable Box(es):
Water Pollution Equipment
Supplies/Consumables
Itemized description of items purchased (For the municipal property tax exemption include date acquired, date installed, and purchase price. These
items must also be included on the Declaration of Personal Property):
Declaration by Purchaser
The item(s) described above are tangible personal property to be used or consumed by a business in the operation of facilities for the
treatment of industrial waste before the discharge of industrial waste into any waters of the state or into any sewerage system emptying
into the waters, the primary purpose of which is the reduction, control, or elimination of water pollution, certified as approved for the
purpose by the Commissioner of the Department of Environmental Protection.
In accordance with Conn. Gen. Stat. §12-412(21), the purchase of these item(s) is exempt from sales and use taxes.
In accordance with Conn. Gen. Stat. §12-81(51), these items may be exempt from municipal property tax. Describe the items above and
include on the Declaration of Personal Property.
Declaration: I declare under penalty of law that I have examined this return or document (including any accompanying schedules and
statements) and, to the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering
a false return or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both.
____________________________________
Name of Purchasing Business
BY: __________________________________________
_________________________________
______________________
Authorized Signature of Owner or Officer
Title
Date
CERT-124 (Back)
(Rev. 01/05)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Cert-117 1/05 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Air Pollution Control Facilities - State Of Connecticut Department Of Revenue Services
Financial
Form Cert-124 - Certificate For Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Water Pollution Control Facilities
Financial
Form Cert-124 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Water Pollution Control Facilities
Financial
Form Cert-117 - Certificate For Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Air Pollution Controll Facilities
Legal
Form Cert-117 - Purchases Of Tangible Personal Property Incorporated Into Or Consumed In Air Pollution Control Facilities
Financial
Form Cert-113 - Certificate For Purchases Of Tangible Personal Property And Services By A Nonprofit Nursing Home, Nonprofit Rest Home Or Nonprofit Home For The Aged
Legal
Form Cert-113 - Certificate For Purchases Of Tangible Personal Property And Services By A Nonprofit Nursing Home, Nonprofit Rest Home Or Nonprofit Home For The Aged
Legal
Form Cert-113 - Certificate For Purchases Of Tangible Personal Property And Services By A Nonprofit Nursing Home, Nonprofit Rest Home Or Nonprofit Home For The Aged
Financial
Related Categories
Parent category: Financial