Form St-19 - Sales And Use Tax Certificate Of Exemption - 2016
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1Form ST-19
COMMONWEALTH OF VIRGINIA
SALES AND USE TAX CERTIFICATE OF EXEMPTION
For use by shipping lines engaged in interstate or foreign commerce and
by ship building companies engaged in building, converting, or
repairing ships or vessels used or to be used in
interstate or foreign commerce
To ____________________________________________________________ Date _____________________________
Name of Supplier
________________________________________________________________________________________________
Number and Street or Rural Route
City, Town, or Post Office
State
Zip Code
The Virginia Retail Sales and Use Tax Act provides that the Virginia sales and use tax shall not apply to the kinds and
classes of tangible personal property shown in Items 1 through 3 below when purchased for the purposes and under the
conditions set out in Items 1 through 3 below.
The undersigned purchaser hereby certifies that all tangible personal property purchased from the above named supplier
on and after this date will be purchased for the purpose indicated below, unless otherwise specified on each order, and
that this Certificate shall remain in effect until revoked in writing by the Department of Taxation. Check proper box below.
1. Ships or vessels used or to be used exclusively or principally in interstate or foreign commerce.
c
2. Tangible personal property used directly in the building, conversion, repair, or alteration of ships or vessels
c
plying the high seas, either in intercoastal trade between ports in this State and ports in other States of the
United States or its territories or possessions, or in foreign commerce between ports in this State and ports
in foreign countries.
3. Fuel and supplies for use or consumption aboard ships or vessels plying the high seas, either in intercoastal
c
trade between ports in this State and ports in other States of the United States or its territories or
possessions, or in foreign commerce between ports in this State and ports in foreign countries, for delivery
directly to such ships or vessels.
Virginia Account
Name of Purchaser ________________________________________ No., if any ____________________________
Trading As ______________________________________________________________________________________
Address ________________________________________________________________________________________
Number and Street or Rural Route
City, Town, or Post Office
State
Zip Code
Kind of business engaged in by dealer
________________________________________________________________________
I declare that I am authorized to sign this Certificate of Exemption and that, to the best of my knowledge and belief, it is true
and correct, made in good faith, pursuant to the Virginia Retail Sales and Use Tax Act.
By
__________________________________________________________
___________________________________________
Signature
Title
If the purchaser is a corporation, an officer of the corporation or other person authorized to sign on behalf of the corporation
must sign; if a partnership, one partner must sign; if a sole proprietorship, the proprietor must sign.
Information for supplier - A supplier is required to have on file only one Certificate of Exemption properly executed by each
purchaser buying or leasing tax exempt property under this Certificate.
Va. Dept. of Taxation
6201067
Rev. 03/16
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