Form S-3c - Vermont Sales Tax Exemption Certificate For Contractors
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1
2Vermont Sales Tax Exemption Certificate
for
Form
S-3C
CONTRACTORS
32 V.S.A. §9743(1)-(4), §9441(39)
To be filed with the SELLER, not with the VT Department of Taxes.
Complete one
c
Single Purchase - Enter Purchase Price $ _________________
exemption certificate
c
Multiple Purchase (effective for subsequent purchases.)
for EACH project
Federal ID
Number
Name
For Individuals/Partnerships
Social Security
Business Name
Number
Telephone
Number
Address
City
State
Zip
Seller’s
Name
Address
City
State
Zip
Organization’s
Name
Address
City
State
Zip
Exempt as:
c 501(c)(3) Registered in Vermont. Vermont Account Number _____________________________
c United States of America - Agency __________________________________________________
c State of Vermont or Subdivision - Name _____________________________________________
c Organization covered by V.S.A. Title 10, Chapter 11(A)
c Qualifying Manufacturing Facility 32 V.S.A. 9741(39)(i)
c Qualifying Downtown Redevelopment Facility 32 V.S.A. 9741(39)(ii)
Project
Location
Starting
Approximate
Date
Completion Date
I certify that, to the best of my knowledge and belief, the statements provided here are true and
correct.
Signature of Buyer or Authorized Agent
Title
Date
Form S-3C
This form may be photocopied.
Rev. 5/03
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