Form St-16 - Contractor'S Certificate - City Of Colorado Springs printable pdf download

Form St-16 - Contractor'S Certificate - City Of Colorado Springs

SALES TAX DIVISION

ST-16

CONTRACTOR’S CERTIFICATE

STATE OF COLORADO)

SS:

COUNTY OF EL PASO )

I, _______________________________________________, of lawful age, being first duly sworn, depose and state: That I am the

Contractor Name

_____________________ of ______________________________________________________ contractor for the construction of a

Title

Company/Business Name

___________________________ for ________________________________________________,In the county of El Paso, State of

Type of Construction/Structure

Owner Name of Construction/Structure Project

Colorado: that the City of Colorado Springs Sales Tax in the amount of $_______________________________, and that Use Tax in

Amt. Of Sales Tax paid to Supplier

The amount of $_______________________, which said_____________________________________ seeks to have refunded/seeks

Amt. Of Use Tax paid to City

Name of owner on Construction/Structure Project

to have final retainage released, that the Sales and/or Use Tax was paid by said contractor between the dates of______YR_____

and ________________YR___________________; that the tangible personal property upon which City of Colorado Springs tax was

paid, was built into the above mentioned _________________________________________. (See attached form, schedule ST-16A)

Type of Structure

Affiant further states that the books, records and other substantiating evidence of payment of said taxes are located at _____________

________________________________________________in said County and State: and that the same are open to inspection by the

Company Address-Street Address, City, State, Zip

Director of Finance of Colorado Springs.

I, hereby certify, under penalty of perjury, that the statements made herein are to the best of my knowledge true and correct.

________________________________________

___________________

Contractor Signature

Date

Must be signed by owner of company or officer of corporation

30 S. Nevada Ave., Suite 203 • TEL 719 385-5903

Mailing Address: Post Office Box 2408, Mail Code 225 • Colorado Springs, Colorado 80901-2408

Form St-16 - Contractor'S Certificate - City Of Colorado Springs