Form St-28j - Interstate Common Carrier Exemption Certificate - Kansas Department Of Revenue
ADVERTISEMENT
1
2KANSAS DEPARTMENT OF REVENUE
INTERSTATE COMMON CARRIER EXEMPTION CERTIFICATE
The undersigned motor carrier certifies that the tangible personal property or service purchased from:
Seller
:
_________________________________________________________________________________________________
Business Name
Address:
_________________________________________________________________________________________________
Street, RR, or P.O. Box
City
State
Zip + 4
is exempt from Kansas sales and compensating use tax for the following reason (check one box):
K.A.R. 92-19-28 and K.A.R. 92-20-18 exempt the sale of rolling stock (including buses and trailers), repair or
replacement materials and parts, gasoline, distillate and other motor fuels when purchased by a motor carrier qualifying
as a public utility, for immediate and direct use in interstate commerce. The qualifying motor carrier may be engaged
in interstate commerce exclusively, or in both interstate and intrastate commerce.
Description of tangible personal property purchased: ____________________________________________
__________________________________________________________________________________________
The undersigned motor carrier further certifies that he or she qualifies as a public utility on the following basis:
(Check one box and complete the information requested.)
G
I have ICC authority for hauling regulated commodities. My ICC number is: ________________________________
My ICC authority is under the name of: _____________________________________________________________
G
I have ICC authority for hauling exempt (unregulated) commodities. My KCC number is: ______________________
My KCC authority is under the name of: ____________________________________________________________
G
I do not have any ICC authority but am leased to a holder of ICC authority for hauling regulated and/or exempt commodities.
My Kansas Sales Tax Number is: ____________________________
I am leased to: ________________________________________________________________________________
Lessor’s Name
Lessor’s Address: _____________________________________________________________________________
Street, RR or P.O. Box
City
State
Zip + 4
Address: _____________________________________________________________________________________
Lessor’s ICC Number: __________________________ Lessor’s KCC Number: ___________________________
CHARGES FOR LABOR SERVICES TO SERVICE, MAINTAIN, OR REPAIR ROLLING STOCK, INCLUDING BUSES
AND TRAILERS, ARE TAXABLE.
The undersigned motor carrier understands and agrees that if the tangible personal property is not used immediately and
directly in interstate commerce or is used for any other purpose that is not exempt from sales or compensating tax, the
undersigned motor carrier becomes liable for the tax.
Purchaser
: _________________________________________________________________________________________________
Motor Carrier Name
Address:
_________________________________________________________________________________________________
Street, RR, or P.O. Box
City
State
Zip + 4
Authorized Signature: _____________________________________________________
Date
: ___________________
THIS CERTIFICATE MUST BE COMPLETED IN ITS ENTIRETY.
(See reverse for additional information and instructions.)
ST-28J (Rev. 2/05)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial