Form St-Pe1 Application For Certificate Of Exemption Production Equipment Or Services For Film Producers Or Film Production Companies Page 2

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APPLICATION INSTRUCTIONS
1. Provide the title of the film or video project and the producer's name.
2. Provide the legal name of the production company and the Federal Employer Identification Number
3. Provide the mailing street address, city, state, zip code, and telephone number of the production
company.
4. Provide the Georgia address information for the company or shoot location.
5. Provide the name, telephone number, and e-mail address of the production company's primary contact
person.
6. Provide the contact e-mail address.
7. Provide the type of production project (Feature Film, Commercial, TV Series, etc.).
8. Provide the production's intended geographic distribution area (International, Nationwide, or Georgia).
9. Provide the intended type of distribution format (VHS, BETA, DVD, Film, etc).
10. Check the type of equipment under which this application is being submitted (Purchase, Rented, Leased
or All). Leases are rentals that exceed 30 days.
11. Provide a range of anticipated dates the equipment will be purchased, rented or leased.
12. List the anticipated equipment and purchase price for which this application is being submitted.
This application must be submitted to the Georgia Film, Video & Music Office at Suite 1200, 75 Fifth Street, NW,
Atlanta, GA 30308 OR FAX to (404) 962-4053 for certification of the film or video project. Upon the projects
certification, the application and certification will be forwarded by the Georgia Film, Video & Music Office to the
Georgia Department of Revenue for consideration and issuance of a Certificate of Exemption, Form ST-PE2, for
the qualifying equipment requested under this application.

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