Form St-L-137fa - Commercial Agriculture Application Form

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MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
APPLICATION FORM
Commercial Agriculture
To obtain a sales tax exemption card for the purchase of Depreciable Machinery, Equipment or Repair parts
and Electricity for use in Commercial Agricultural Production.
THIS APPLICATION MUST BE ACCOMPANIED BY ALL THE
INFORMATION REQUESTED BELOW UNDER
“SPECIFIC REQUIREMENTS”
CURRENT OR PREVIOUS EXEMPTION NUMBER FA#___________________ (if applicable)
ORIGINAL BUSINESS START DATE:___________________
1. Federal Identification Number or Social Security Number______________________________________________________
2. Name of Corporation or Name of Individual _________________________________________Phone #_________________
3. Mailing Address_______________________________________________________________________________________
4. City__________________________________________________State____________Zip Code________________________
5. E-Mail Address: _______________________________________________________________________________________
6. List all of your business activities and amount of time devoted to each:_____________________________________________
____________________________________________________________________________________________________
If you have any questions regarding eligibility requirements, restrictions, and issuance of exemption cards, please refer to
Instructional Bulletin 45 and Rule 323. These publications are available on our web site at:
and
Note: All information included with this application is subject to VERIFICATION by Maine Revenue Services.
Maine Revenue Services may request additional information or documentation necessary to determine eligibility for an
exemption certificate.
“I certify under the pains and penalty of perjury that I am engaged in Commercial Agricultural Production and that the
statements made in this application and any supplements attached thereto are true, accurate, and complete to the best of
my knowledge and belief.”
_________________________________________________
Signature of Owner, Partner or Corporate Officer
_________________________________
_____________________________
__________________________________
Print Name
Title
Date
(See Page 2 for Specific Instructions and Information Required)
Phone: (207) 624-9693
E-mail: sales.tax@maine.gov
Fax: (207) 287-6628
1
TTY 888-577-6690

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