Form 51a111 - Certificate Of Exemption, Machinery For New And Expanded Industry - 2007

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51A111 (1-07)
CERTIFICATE OF EXEMPTION
Commonwealth of Kentucky
MACHINERY FOR NEW AND EXPANDED INDUSTRY
DEPARTMENT OF REVENUE
IMPORTANT: Certificate not valid unless completed in full.
This certificate may be executed only for purchases, leases or rentals of tangible personal property which qualify for
exemption under KRS 139.170, KRS 139.480(10) and Regulation 103 KAR 30:120. The certificate may be executed by
either: (1) a manufacturer or production processor; or (2) jointly by a contractor and the manufacturer or production processor
in any case in which a contractor under contract with the manufacturer or production processor does, in fact, purchase, lease
or rent such property.
THE UNDERSIGNED HEREBY CERTIFIES: That the machinery to be purchased, leased or rented from
Name of Vendor, Lessor or Renter
Address
constitutes “machinery for new and expanded industry,” as defined in Sales and Use Tax Regulation 103 KAR 30:120, and
that this machinery is to be installed at
Name, if any, and Address of Plant Location
The undersigned agrees that in the event it is determined that any of the property described below is not tax-exempt, the
undersigned will immediately report and pay the required tax measured by the purchase price or by the lease or rental payment
of the property.
Cost of machinery to be purchased_____________________Purchase order number_________________________
Description of machinery to be purchased
Describe manufacturing function of machinery
Name of Manufacturer or Production Processor
Name of Contractor Under Contract with the Manufacturer
or Production Processor
Name of Subcontractor
Permit Account Number
Job Number/Contract Number
By
By
Signature
Title
Signature
Title
Date
Date
Address
Address
Contractor’s Note: This certificate may not be used to purchase or rent/lease construction equipment or consumable supplies used in fulfilling a contract.
Caution: Sellers failing to obtain a completed certificate will be held liable for the sales and use tax pursuant to the good faith provisions of KRS 139.270.
A seller of tangible personal property shall be relieved from the sales and use tax only if he maintains a file of these certificates for a period of not less than
four years as provided by KRS 139.720.

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