Form Reg-8 - Application For Farmer Tax Exemption Permit - Ct Department Of Revenue Services

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Department of Revenue Services
For DRS Use Only
Taxpayer Services Division
Form REG-8
Connecticut Tax Registration Number
25 Sigourney Street
Hartford CT 06106-5032
Application for Farmer Tax Exemption Permit
REG-8 (Rev. 07/08)
Approved
Denied
TPS #
Complete the application in blue or black ink only. Read the instructions before completing this form.
Section 1
Name of Applicant (sole proprietor, partnership, corporation, or LLC)
Social Security Number (SSN) (individual)
Spouse’s First Name and Middle Initial
Last Name
(if joint application)
Spouse’s SSN
Address
Number and Street
PO Box
Federal Employer ID Number (FEIN) (other)
Telephone Number
City, Town, or Post Offi ce
State
ZIP Code
(
)
Check One:
Check One:
Purchased existing farm
Individual
Farm Name
Changed business
Partnership
structure
Corporation
New applicant
SMLLC
Farm Location
Number and Street
Town
Renewal
LLC
Start-up farmer
LLP
(See instructions.)
Fiduciary
1. Were you engaged in agricultural production as a trade or
2. Farmland ownership: Check one.
business during the preceding taxable year? See instructions.
Own
Lease
Own part and lease part
Yes
No
4. What farm products including livestock did you raise during the
preceding taxable year? See instructions. ________________
3. Total acreage of farm: ________________________________
Total acres you used in agricultural production during the
6. Have you been issued a Sales and Use Tax Permit by the
preceding taxable year: _______________________________
Department of Revenue Services (DRS)?
Yes
No
5. What farm products including livestock will you raise during the
8. If you answered Yes to 6 or 7, enter your Connecticut Tax
next two years? See Instructions. _______________________
Registration Number. __________________________________
Do not enter Farmer Tax Exemption Permit Number or FEIN.
7. Do you have employees?
Yes
No
9. State the gross income you derived solely from agricultural production as reported
on your federal income tax return. See instructions.
In 20 ____
9a. $
00
.
In 20 ____
9b. $
00
Total: Add Lines 9a and 9b.
9c. $
0
00
Average: Divide Line 9c by 2.
9d. $
00
10. If the amount entered on Line 9b or Line 9d is less than $2,500 but you qualify because you purchased an existing agricultural
business in the current or immediately preceding taxable year, enter the following information. See instructions.
Seller’s Name
Seller’s Farmer Tax Exemption Permit Number
Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my
knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to DRS is a fi ne of not more
than $5,000, or imprisonment for not more than fi ve years, or both. The declaration of a paid preparer other than the taxpayer is based on all information
of which the preparer has any knowledge.
Applicant’s Name (Print)
Applicant’s Signature
Date
Sign Here
Keep a
copy of this
Spouse’s Name (Print, if a joint application)
Spouse’s Signature
Date
application
for your
records.
GO TO PAGE 2

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