Form St-135 - Sales And Use Tax Exemption Certificate - Indiana Department Of Revenue - 2010
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1Indiana Department of Revenue
Form ST-135
State Form 47838
Sales and Use Tax Exemption Certifi cate
(R2 / 11-10)
For Purchases by Persons Engaged in Public Transportation*
Operating Under Leases or Contracts to Certifi ed Motor Carriers.
To qualify for the exemption, the tangible personal property purchased must be predominately used in providing public transportation. The tangible
personal property is predominately used in public transportation if more than 50% of its use is attributable to transporting people or property for hire.
Print Name of Purchaser:
FID, SSN, TID, or USDOT #
FHWA # (formerly ICC #)
Intrastate Carriers IMCA #
(formerly PSCI or IURC #)
Street Address
City
State
Zip
□
□
□
□
□
Check Applicable Box
Vehicle
Repair Parts
Tires, Tubes or Accessories
Fuel, Lubricants
Other
for Purchase of:
If Other, Describe: _______________________________________________________________________
______________________________________________________________________________________
□
□
Check One:
Single Purchase
Blanket Purchases
Enter Purchase Price $ _____________________
Effective Date: From _____________ To _____________
*See Reverse Side
I hereby certify the property purchased by use of this exemption certifi cate will be used directly in rendering public transportation under lease or contract
to a certifi ed motor carrier in accordance with IC 6-2.5-5-27.
Signature: _______________________________________________________________________ Date: _______________________________
Purchases made with this certifi cate are limited to the above mentioned items. Improper use of this certifi cate constitutes perjury and is punishable by
law.
Indiana Department of Revenue
Form ST-135
State Form 47838
Sales and Use Tax Exemption Certifi cate
(R2 / 11-10)
For Purchases by Persons Engaged in Public Transportation*
Operating Under Leases or Contracts to Certifi ed Motor Carriers.
To qualify for the exemption, the tangible personal property purchased must be predominately used in providing public transportation. The tangible
personal property is predominately used in public transportation if more than 50% of its use is attributable to transporting people or property for hire.
Print Name of Purchaser:
FID, SSN, TID, or USDOT #
FHWA # (formerly ICC #)
Intrastate Carriers IMCA #
(formerly PSCI or IURC #)
Street Address
City
State
Zip
□
□
□
□
□
Check Applicable Box
Vehicle
Repair Parts
Tires, Tubes or Accessories
Fuel, Lubricants
Other
for Purchase of:
If Other, Describe: _______________________________________________________________________
______________________________________________________________________________________
□
□
Check One:
Single Purchase
Blanket Purchases
Enter Purchase Price $ _____________________
Effective Date: From _____________ To _____________
*See Reverse Side
I hereby certify the property purchased by use of this exemption certifi cate will be used directly in rendering public transportation under lease or contract
to a certifi ed motor carrier in accordance with IC 6-2.5-5-27.
Signature: _______________________________________________________________________ Date: _______________________________
Purchases made with this certifi cate are limited to the above mentioned items. Improper use of this certifi cate constitutes perjury and is punishable by
law.
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