Looking for a Colorado Tax Forms And Templates? Download it for free!

Form Dr 1260 - Sales Tax Exempt Certificate Electricity & Gas For Domestic Consumption Form

DR 1260 (08/30/13)

*141260==19999*

COLORADO DEPARTMENT OF REVENUE

Denver CO 80261 - 0009

(303) 238-SERV(7378)

Sales Tax Exempt Certificate Electricity

& Gas For Domestic Consumption

Note: Exemption certificate must be signed and filed with your proper utility company. The utility company will

exempt the account from sales taxes on utilities, except for the taxes of those local entities which do not

allow for this exemption.

Name of Utility Company

Address or P.O. Box Number

City

State

Zip

Last Name of Applicant (as shown exactly on the utility billing)

First Name

Middle Initial

From

Address or P.O. Box Number (as shown exactly on the utility billing)

City

State

Zip

Utility Account Number

For the purpose of this exemption, the term "residential use" has the following meaning: the use of gas or electricity by

the individual customer exclusively for domestic purposes such as lighting, refrigeration, cooking, water heating, space

heating and air conditioning, in a private home or individual living unit served through a single meter or a master metered

multi-unit apartment, condominium, townhouse or mobile/trailer home used exclusively for domestic purposes. Residential

use includes service to buildings appurtenant to the residence, including garages, barns and other minor buildings for

use of the residents served through the residential meter.

Residents of multi-unit apartments, mobile/trailer home parks or condominium and townhouse associations, who are

being billed through a master meter and who are taking service under a commercial rate, but nevertheless qualify for

this exemption because the use is exclusively for domestic purposes, must file this form with their proper utility company.

If, upon audit of the account by the Department of Revenue, a determination is made that the account does not meet

the requirements as outlined above, taxes, penalties, and interest may be assessed to the owner claiming exemption.

Under penalties of perjury, I swear or affirm that the gas and/or electric service which is billed to the above applicant,

under a commercial rate, by the supplier named herein is used exclusively for residential use and therefore qualifies for

exemption from Colorado State Sales and Use Tax.

Authorized Signature

Title

Date

(MM/DD/YY)

Form Dr 1260 - Sales Tax Exempt Certificate Electricity & Gas For Domestic Consumption Form