Form St: Ex-A2 - Application For Sales And Use Tax Certificate Of Exemption - 2011
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1ST: EX-A2
A
D
R
LABAMA
EPARTMENT OF
EVENUE
9/11
S
U
T
D
ALES AND
SE
AX
IVISION
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Application For
Sales and Use Tax Certificate of Exemption
For an Industrial or Research Enterprise Project
This Certificate of Exemption will be limited to purchases which qualify for an abatement of
sales and use taxes pursuant to Code of Alabama 1975, Section 40-9B-1, et seq.
APPLICANT’S LEGAL NAME
FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
MAILING ADDRESS
CITY, STATE, AND ZIP
ADDRESS OF THE PROJECT SITE
CONTACT PERSON
IF CONTRACTOR APPLICATION, NAME OF PRIVATE USER
BUSINESS PHONE NUMBER
DATE ABATEMENT WAS GRANTED
ESTIMATED PROJECT COMPLETION DATE PER ABATEMENT AGREEMENT
(
)
A prime contractor must attach written confirmation from the private user that it will be making
purchases of tangible personal property to be incorporated into the project referenced above. A con-
tractor or subcontractor must attach written confirmation from the private user or the prime contractor
that it will be making purchases of tangible personal property to be incorporated into the project refer-
enced above.
The undersigned hereby makes application for a certificate of exemption (Form STE-2) in accor-
dance with the provisions of Sales and Use Tax Rule 810-6-4-.24 and further agrees to abide by the pro-
cedures outlined in Sales and Use Tax Rule 810-6-4-.24.01.
Name ______________________________________________________
Mail to:
(PLEASE PRINT)
Alabama Department of Revenue
Signature ___________________________________________________
Attn: Abatement Program Administrator
P. O. Box 327001
Montgomery, AL 36132-7001
Title ________________________________________________________
(334) 242-1175
Date ________________________________________________________
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