Form 31-113 - Iowa Sales Tax Exemption Certificate-Energy Used In Processing /agriculture Page 2

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Iowa Sales Tax Exemption Certificate
Energy Used in Processing /Agriculture
EXEMPTION PERCENTAGE CALCULATION
Complete the calculation below for each meter that measured energy use for both exempt and nonexempt purposes.
If documentation cannot be completed on this form, attach additional pages.
Period used for basis of computation. Consider seasonal operations when selecting period.
__________________ through ___________________
(A)
(B)
(A)
(B)
Exempt
Energy Used
Hours
Total
Nonexempt
Energy Used
Hours
Total
Activity
(watts/ccf)/hour
of Use
(A x B)
Activity
(watts/ccf)/hour
of Use
(A x B)
__________
_________________
_____
_____________
Lighting
_________________
_____
_____________
__________
_________________
_____
_____________
Heating/AirCon. _________________
_____
_____________
__________
_________________
_____
_____________
Office Equip.
_________________
_____
_____________
__________
_________________
_____
_____________
Refrigeration
_________________
_____
_____________
__________
_________________
_____
_____________
Maintenance
_________________
_____
_____________
__________
_________________
_____
_____________
Other, specify
_________________
_____
_____________
__________
_________________
_____
_____________
__________
_________________
_____
_____________
__________
_________________
_____
_____________
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_________________
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_________________
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_________________
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__________
_________________
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_________________
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__________
_________________
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_________________
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__________
_________________
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_________________
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_________________
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_________________
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_________________
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_________________
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_________________
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_________________
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_________________
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_________________
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__________
_________________
_____
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__________
_________________
_____
_____________
TOTAL EXEMPT USE: ______________
TOTAL NONEXEMPT USE: ______________
TOTAL USE: _____________ EXEMPT % ______________
NONEXEMPT % ______________
31-113b (08/17/09)

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