Form St-11a - Sales And Use Tax Certificate Of Exemption
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1COMMONWEALTH OF VIRGINIA
FORM ST-11A
SALES AND USE TAX CERTIFICATE OF EXEMPTION
(For use by construction contractors and non-manufacturers when purchasing tangible personal property for the specific reason set fourth below)
, _______
To: __________________________________________________ Date _________________________________________________
(Name of Supplier)
(State)
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The undersigned purchaser herby certifies that all tangible personal property purchased from the above named suppliers is exemp t
§
from sales and use taxation under Virginia Code
58.1-609 and are purchased for the exempt purpose or purposes indicated below.
(Check proper box below.)
1.
Machinery or component parts thereof used directly in manufacturing, processing, refining, mining or conversion of products for sale or
resale;
items used directly in the drilling, extraction, refining or processing of natural gas or oil for sale or resale and in well area reclamation
activites required by federal or state law;
tangible personal property used by a public service corporation or telecommunications company
directly in the rendition of its public service;
broadcasting equipment and parts and accessories thereto and towers used by radio and televi-
sion stations and cable television systems; and
tangible personal property purchased for use or consumption directly and exclusively in basic
research or research and development in the experimental or laboratory sense. TANGIBLE PROPERTY INCORPORATED INTO REAL PROP-
ERTY IS NOT EXEMPT FROM THE TAX.
(Name of Manufacturer, Processor, Miner, Gas/Oil Driller, Public Service Corporation, Commercial Radio or Television or Cable Television Company)
Address ____________________________________________________________________________________________________________
(Completion Date)
2. Tangible personal property incorporated into real property in another state or foreign country which could be purchased free from the tax in such
state or foreign country. EQUIPMENT, TOOLS ETC. USED IN THE PERFORMANCE OF THE CONSTRUCTION PROJECT ARE NOT
EXEMPT FROM THE TAX.
(Name of Owner of the Construction Project)
Address ____________________________________________________________________________________________________________
(Completion Date)
3. Tangible personal property, necessary for agricultural production, to be affixed to real property owned or leased by a farmer engaged in agricul-
tural production for market. STRUCTURAL CONSTRUCTION MATERIALS ARE NOT EXEMPT FROM THE TAX.
(Name of Farmer)
Address ____________________________________________________________________________________________________________
(Completion Date)
4. State certified pollution control equipment and facilities used primarily for the purpose of abating or preventing pollution of the atmosphere or
the waters of the Commonwealth of Virginia for installation in or on the premises owned or leased by:
(Name of Manufacturer or Non-Manufacturer)
Address ____________________________________________________________________________________________________________
(Certifying Agency)
(Date of Certification)
(Name of Project)
(Project Completion Date)
Name of Purchaser ____________________________________________________________ Trading Date ________________________________
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I certify that I am authorized to sign this Certificate of Exemption and that, to the best of my knowledge and belief, it is tr ue and correct,
made in good faith, pursuant to the Code of Virginia.
By _________________________________________________________________________ Title _______________________________________
(Signature)
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 an unincorporated association, a member must sign; if a sole proprietorship, the
proprietor must sign.
1. INFORMATION TO PURCHASER. This certificate of exemption can only be used to purchase tax exempt tangible personal
property for this particular project, and it cannot be used after the completion date of this particular project.
2. INFORMATION TO SUPPLIER. A supplier is required to have on file for each project only one certificate of exemption
properly executed by each purchaser buying tax exempt tangible personal property for the purpose indicated thereon.
Do not write in this box
VA DEPT OF TAXATION
6201058
REV 6/99
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