Form S-3c - Sales Tax Exemption Certificate For Contractors Completing A Qualified Exempt Project

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Vermont Sales Tax Exemption Certificate
for
Form
CONTRACTORS COMPLETING A QUALIFIED EXEMPT PROJECT
S-3C
(listed below)
32 V.S.A. § 9743(1)-(4), § 9741(39)
Complete one exemption certificate for EACH project
To be filed with the SELLER, not with the VT Department of Taxes.
c Single Purchase - Enter Purchase Price $ _________________
c Multiple Purchase (effective for subsequent purchases.)
Name
Federal ID Number
For Individuals/Partnerships
Business Name
Social Security
Number
Address
Telephone Number
City
State
Zip
Seller's Name
Address
City
State
Zip
Organization's Name
Address
City
State
Zip
Exempt as:
c 501(c)(3) Registered in Vermont. Vermont Sales and Use Tax Account Number _________________________
c United States of America - Agency ____________________________________________________________
c State of Vermont or Subdivision - Name ________________________________________________________
c Local Development Corporation covered by 10 V.S.A., Chapter 12
c Qualifying Downtown Redevelopment Facility 32 V.S.A. § 9741(39)(ii)
Project
Starting Date
Approximate Completion Date
I certify that I have read and complied with the instructions provided with respect to the use of this
Exemption Certificate. I further certify that the above statements are true, complete, and correct,
and that no material information has been omitted.
Signature of Buyer or Authorized Agent
Title
Date
Form S-3C
This form may be photocopied.
Rev. 09/13

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