Form Cert-133 - Contractor'S Exempt Purchase Certificate For A Renovation Contract With A Direct Payment Permit Holder

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Department of Revenue Services
State of Connecticut
25 Sigourney Street
Hartford CT 06106-5032
CERT-133
(Rev. 01/05)
Contractor’s Exempt Purchase Certificate
for a Renovation Contract With a Direct Payment Permit Holder
(This certificate may not be used for new construction.)
I declare I am engaged in performance of a renovation construction contract for the following Direct Payment Permit holder:
Connecticut Tax Registration Number of Direct Payment Permit Holder: _________________________________________________
Name of Direct Payment Permit Holder: ___________________________________________________________________________
Address: ____________________________________________________________________________________________________
Project Name and Address: ____________________________________________________________________________________
The contractor or subcontractor must attach a copy of the direct payment permit to this certificate.
Construction Contracts Entered Into With Direct Payment Permit Holders: The contractor must purchase materials and supplies that
are to be installed or placed in a project performed under this renovation contract and that will remain in the project after its completion
without payment of sales and use tax. The contractor will not charge the Direct Payment Permit holder any sales or use tax on the
materials and supplies. This includes tangible personal property that remains tangible personal property after its installation or
placement. For such exempt purchases, the contractor must furnish the contractor’s suppliers a completed certificate for each project.
Note: The General Contractor’s Information and Declaration Section must be completed in full. Notice to Nonresident Contractors:
This certificate does not supersede any bonding requirements previously established by the Department of Revenue Services (DRS).
For More Information: Call Taxpayer Services at 1-800-382-9463 (in-state) or 860-297-5962 (from anywhere). TTY, TDD, and Text
Telephone users only may transmit inquiries anytime by calling 860-297-4911. Preview and download forms and publications from the
DRS Web site at
General Contractor’s Information and Declaration Section: 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.
Connecticut Tax Registration Number of General Contractor: __________________________________________________________
Name of General Contractor: ____________________________________________________________________________________
Authorized Signature: __________________________________________________________________ Date: ___________________
Address: _____________________________________________________________________________________________________
Description of Work Performed: __________________________________________________________________________________
____________________________________________________________________________________________________________
Subcontractor’s Information and Declaration Section: 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.
Connecticut Tax Registration Number of Subontractor: ________________________________________________________________
Name of Subcontractor: _________________________________________________________________________________________
Authorized Signature: __________________________________________________________________ Date: ___________________
Address: _____________________________________________________________________________________________________
Description of Work Performed: __________________________________________________________________________________
____________________________________________________________________________________________________________
Name of Contractor You Are Directly Subcontracted to,
if Different from Above: __________________________________________________________________________________________
Notice to Nonresident Contractors: This certificate does not supersede any bonding requirements previously established by DRS.

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