South Dakota Delay In Sales/use Tax Form (Page 2 of 2) in pdf

IV. Ownership Information

If corporation, fill in names of all principal officers.

If partnership, fill in names of all partners. Attach additional sheets if necessary.

Name ______________________________________________________ Social Security Number _______________________________

Address _________________________ City _____________________ State ________________ Zip Code _____________________

Home telephone _____________________________________________ Title ______________________________________________

Name ______________________________________________________ Social Security Number _______________________________

Address _________________________ City _____________________ State ________________ Zip Code _____________________

Home telephone _____________________________________________ Title ______________________________________________

Name ______________________________________________________ Social Security Number _______________________________

Address _________________________ City _____________________ State ________________ Zip Code _____________________

Home telephone _____________________________________________ Title ______________________________________________

V. Agreement and Signatures

Applicant acknowledges and agrees as follows:

1) The applicant has read and is familiar with SDCL 10-45-99 to 10-45-107 pertaining to the delay of payment of sales

tax or use tax for equipment or machinery that will be for direct use in a manufacturing, fabricating or processing

business and agrees to abide by the terms and conditions thereof.

2) Upon receipt of the permit authorized by SDCL 10-45-103, the applicant will submit use tax no later than six

months from the date of the permit. The Department is NOT responsible for notifying applicant of impending

deadlines for use tax payments.

3) The applicant will maintain all supporting documentation, including purchase invoices, cancelled checks, and other

records pertaining to the project cost, at the location set forth in the above application. These records shall be available

for inspection by the Department, its agents and employees, upon request. If applicant fails or refuses to provide these

records upon request by the Department, the Department may, at its sole discretion, refuse to authorize a delay in tax

payment or revoke such right. If an application for a delay is revoked, the tax is due and owing immediately.

The undersigned declare and affirm under the penalties of perjury that they have examined the information contained in the above

application and all such information is, in all things, true and correct.

Dated this _________ day of _________________________________ , 20______.

Signature __________________________________________________ Title _______________________________________________

Mail completed application and attachments to:

SD Department of Revenue & Regulation, Attn: Alison Jares, 445 East Capitol Ave., Pierre, SD 57501

PRINT FOR MAILING

EXIT

CLEAR FORM

South Dakota Delay In Sales/use Tax Form Page 2