Form St-200 - Utility Sales Tax Exemption Application Page 2
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2D.
Summary:
Please explain briefly an overview of your operation.
Not-For-Profit (NFP) Organizations, please explain how the utility is used to further the NFP purpose of the organization.
E.
Supporting Schedule:
(See Instructions)
List all production and non-production equipment with the annual energy consumption on K.W.H., cubit feet or gallons breakdown
per each piece of equipment.
Note: Registered Not-For-Profit organizations and governmental entities do not complete.
F. Certification/Signature
I hereby certify under penalty of perjury that the foregoing is true and correct to the best of my knowledge, that all equipment has
been listed, and that the power ratings of all listed equipment has been visually verified.
Authorized Signature
Date
POA-1 attached
Copy of utility bill attached
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Parent category: Financial