Form Reg-8 - Application For Farmer Tax Exemption Permit
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1
2State of Connecticut
FORM REG-8
Department of Revenue Services
APPLICATION FOR FARMER
FOR DEPARTMENT USE ONLY
Taxpayer Services Division
TAX EXEMPTION PERMIT
Permit Number
25 Sigourney Street, Hartford CT 06106-5032
REG-8(flat) (Rev. 06/99)
Approved
Denied
TPS #
IMPORTANT - Read Instructions on Reverse Side
Before Completing This Form
2000 Farmer Tax Exemption Permits will be valid
from October 1, 1999, or subsequent date of issuance, until September 30, 2000.
Social Security Number (Individual)
Name of Applicant
Federal Employer ID Number (Other)
Home address (Number and Street)
Check One:
Check One:
City, Town or Post Office
State
Zip Code
Individual
New
Partnership
Renewal
Name of Farm
Telephone Number
Corporation
LLC
Name
Location of Farm
LLP
Change
Fiduciary
1. Was the applicant engaged in agricultural production as a trade
2. Applicant:
owns the farmland
leases the farmland
or business during 1998?
Yes
No
(Check one)
owns part and leases part of the farmland
3. Total acreage of farm:
Total acres used in agricultural production by applicant during 1998:
4. What farm products, including livestock, did the applicant
5. What farm products, including livestock, will the applicant
raise during 1998?
raise during 1999?
6. Has the applicant been issued a Sales and Use Tax permit by the
7. Does the applicant have employees?
Yes
No
Department of Revenue Services?
Yes
No
8. If yes to 6 or 7, enter 10-digit Connecticut Tax Registration Number.
(Do not enter Farmer Tax Exemption Permit Number or Federal Employer Identification Number.)
- 0 0 0
9. State the amount of gross income derived solely from agricultural production as reported
on the applicant’s 1998 federal income tax return. (See instructions.)
$
10. If the amount entered on Line 9 is less than $2,500 but the applicant qualifies because the applicant purchased an existing agricultural
business in 1998 or 1999 enter the following information. (See instructions.)
Name of Seller
Seller’s Farmer Tax Exemption Permit Number
Important: All applicants must submit the specified pages of their most recently filed
federal income tax return and the federal Schedule C or Schedule F.
Please refer to General Instructions on the reverse.
Declaration: I declare under the penalty of false statement that I have examined this application and that to the best of my knowledge
and belief it is true, complete and correct. (The penalty for false statement is imprisonment not to exceed one year or a fine not to
exceed two thousand dollars.)
Applicant’s Signature
Spouse’s Signature
Date
Husband and wife must both sign the application if a joint application is filed (See General Instructions).
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