St-M1 - Application For Certificate Of Exemption Machinery For New Manufacturing Plants Form 2001

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ST-M1 (Rev. 12/01)
Department of Revenue
Sales and Use Tax Division
1800 Century Center Boulevard, NE, Ste. 15311
Atlanta, Georgia 30345-3205
Telephone: (404) 417-6649
Clear Form
APPLICATION FOR CERTIFICATE OF EXEMPTION
MACHINERY FOR NEW MANUFACTURING PLANTS
1. Business trade name___________________________________________________________________________________________
2. Mailing address______________________________________________________________________Telephone _______________
3. Machinery to be installed at:______________________________________________________________, Georgia_______________
(zip code)
4.
List the tangible personal property manufactured at this plant
Equipment
a.
b.
c.
d.
5.
List the type of machinery for which exemption is claimed; its function in manufacturing; and estimated cost
Equipment
Function
Cost
a.
b.
c.
d.
6. Will machinery be:
[ ] Purchased
[ ] Leased
[ ] or Both?
7. Anticipated date purchases/leases will begin: _______________________________________ , be completed: __________________
MM/DD/YY
MM/DD/YY
8. Is this manufacturing machinery to be purchased by a contractor as a part of a lump sum contract, which also includes real property
construction: [ ] Yes;
[ ] No? If yes, provide contractor’s name and address.
The undersigned hereby certifies that purchases/leases of machinery to be installed at the above plant location come within the exemption provisions of
O.C.G.A. § 48-8-3(34)(B).
GEORGIA SALES AND USE CERTIFICATE NO.____________________________________________________DATE______________
MM/DD/YY
SIGNATURE_____________________________________________________________________TITLE___________________________
A CERTIFICATE OF EXEMPTION (ST-M2) WILL BE ISSUED ON ALL QUALIFYING MACHINERY.

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