Notification Exempt Contractor Labor - 75% Renovation Project Of A Single-Family Dwelling Or Duplex Form 2003 Page 2
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1
2NOTIFICATION
Exempt Contractor Labor — 75% Renovation Project
nebraska
department
of a Single-Family Dwelling or Duplex
of revenue
NAME AND ADDRESS OF RENOVATION PROJECT
NAME AND ADDRESS OF GENERAL CONTRACTOR
Name of Project
Check this box if there is not a general contractor and
enter the name and address of the project owner.
Name of General Contractor (or Name of Project Owner)
Address of Project
Address
City
State
Zip Code
City
State
Zip Code
Type of Renovation Project
Single-Family Dwelling, designed for occupancy by one family
Duplex, designed for occupancy by two families
Email Address (for notification via email)
Other
Telephone or Cellular Number
Nebraska Identification Number
Approximate total construction cost
(
)
$
Project Description, include information on how the walls will be affected or altered.
1 Enter the total square footage of all floors in the existing building or unit including basement and all
storage areas (exclude garages) ........................................................................................................ 1
2 Line 1 multiplied by seventy-five percent (.75) and enter the result here ............................................ 2
3 The square footage of a room can only be included in line 3 if at least one-half of the length of the
walls (existing or new) in the room are affected or altered. Enter the total square footage of those
rooms in the existing single-family dwelling or duplex that are being renovated in this project. (See
instruction on “Square Footage Calculation”) ..................................................................................... 3
4 If a fixture in the existing building or unit is replaced or reconfigured, enter the square footage of
the area under the fixture, if not already included in line 3. If none, enter -0- ..................................... 4
5 Enter the total of lines 3 and 4 ............................................................................................................ 5
If line 5 is LESS THAN line 2, STOP. The contractor labor in this project is TAXABLE. This Notification is NOT to be
submitted to the Nebraska Department of Revenue.
The contractor labor charges performed in connection with this renovation project are taxable until this Notification is
acknowledged by the Department of Revenue.
The general contractor must retain a copy of the Acknowledgment to document why sales tax was not billed on the
contractor labor charges to the project owner. A Form 13 is used to document tax-free sales of contractor labor between
contractors. A copy of the Acknowledgment is not required to be given to subcontractors when a Form 13 is completed.
The Acknowledgment does not apply to work performed by those persons merely installing or repairing tangible personal
property. Such persons are not performing contractor labor and their labor charges are taxable.
Under penalties of law, I declare that I have examined this notification, and to the best of my knowledge and belief, it is correct and complete.
sign
(
)
here
Signature of General Contractor or Project Owner
Title
Date
Telephone or Cellular Number
Mail this notification to: NEBRASKA DEPARTMENT OF REVENUE, P.O. BOX 98903, LINCOLN, NE 68509-8903
Visit our Web site: , or call 1-800-742-7474 (toll free in NE and IA) or 1-402-471-5729.
ACKNOWLEDGMENT — DEPARTMENT USE ONLY
The Nebraska Department of Revenue Acknowledges
Receipt of this Notification
Confirmation Number ________________________
___________________________________________
Acknowledged by
6-4XX-2003
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