Form Tc-889 - Mineral Production Withholding Tax Exemption Certificate - Utah State Tax Commission Page 2

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For questions, call the Auditing Division, Mineral
Instructions
Withholding Section at (801) 297-4600.
Either complete Part 1 or Part 2, but not both.
If you are an entity claiming exemption under Utah Code 59-6-102(2), complete Part 1.
If you are claiming a pass-through entity exemption, complete Part 2.
Part 1: Exempt Entity Information
Use Part 1 only if you are exempt from the mineral withholding provisions of the Utah Code Section 59-6-102(2), as an
organization exempt from taxes imposed by Utah Code Chapter 7, Corporate Franchise and Income Taxes, in accordance
with Subsection 59-7-102(1)(a).
Other entities exempt under law from mineral withholding are:
1. United States Government or an agency or subdivision of the United States Government;
2. Utah State Government or an agency or subdivision of the State of Utah; and
3. Native American or Native American Tribe, if the amounts accruing are subject to the supervision of
the United States or its agency or subdivision.
No exemption certificate is required for these other entities.
Part 2: Pass-Through Entity Information
Use Part 2 only when the recipient of mineral production payments will be making further distributions.
Before this certification can be processed, you must include a schedule showing the well number, name
and state API number.
Send completed original form, along with the schedule to:
Auditing Division
Utah State Tax Commission
210 North 1950 West
Salt Lake City, Utah 84134-2300
The Tax Commission will approve or deny the certificate and return a copy to the company
requesting the exemption, along with a copy of the well numbers, to the company disbursing funds.

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