Form 72-415 - Application For Permit To Remit Sales And Use Tax Directly To Agency

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Form 72-415 (Rev. 9/02)
FOR OFFICE USE ONLY
Mississippi State Tax Commission
USE TAX NO.
Route To:
Sales Tax
Application for Permit
EXPIRATIO N DATE
Bureau
To Remit Sales and Use Tax Directly to Agency
PERMIT NO.
Check Purpose for Requesting Direct Pay Permit :
Qualified Industry
:
Manufacturer
Public Utility
Casino
Other
(check one)
The permit to remit tax directly to the State Tax Commission is only available to certain eligible industries due to multiple rates of tax. Al l other industries must remit tax to
the vendors.
Bond Proceeds Exemption
MBFC Certificate Number
Thi s exemption from state sales/use tax is good on purchases made with bond proceeds issued under Sections 57-10-1 et seq., 57-61-1 et seq., and 57-71-1 et seq. by the
Mississippi Business Finance Corporation (MBFC). The Direct Pay Permit for this exemption will be recinded when the bond money is depl e ted and tax will once again be
due to the vendor if applicant is NOT a qualified industry.
Regional/National Headquarters Exemption
Thi s exemption from state sales/use tax is good on purchases of component materials, machinery and equipment used in the initial construction of or expansion to a building
for a business establi s hing or transferring their regional or national headquarters. This exemption will expire three (3) months after completion of the construction. At that
time, the Direct Pay Permit for this exemption wi l l be recinded and tax due will once again be due to the vendor, i f applicant is NOT a qualified i n dustry.
Major Economic Project Exemption
MDA Certificate Number
Thi s exemption is good on purchases or leases of component materials, machi n ery and equipment used in the initial construction of or expansion to a building for a business
establishing or operating as a Major Economic Project as defined by Section 57-75-5(f)(iv)1. The Mississippi Development Authority (MDA) approves such project and issues
a certificate number which is needed for this appl i cation. Thi s exemption will expire three (3) months after completi o n of the construction. At that time, the Direct Pay Permit
for this exemption will be recinded and tax due will once again be due to the vendor, if applicant is NOT a qualified industry.
GAP Area Exemption
MDA Certificate Number
Thi s exemption is good on purchases of component material s , machinery and equipment for the initial construction of or expansion to a building for a business operating in a
Growth and Prosperity (GAP) Area as defined by Section 57-80-1 et seq. The Mississippi Development Authority (MDA) approves such business and issues a certificate
number which is needed for this application. This exempti o n wil l expire three (3) months after completion of the construction. At that time, the Direct Pay Permit for this
exemption will be recinded and tax due will once again be due to the vendor, if applicant is NOT a qualified industry.
Broadband Technology Exemption
Thi s exemption is good on purchases of equipment used in the deployment of broadband technologies from July 1, 2003 to June 30, 2013.
Contractor for Qualified Construction or Expansion
MDA Certificate Number
When a business qualifies for one of the incentive exemptions listed above and employs a contractor to perform the construction activi t y, the contractor will receive the same
exemption as the busi n ess with the same limitations on purchases and time. The Mississippi Development Authority (MDA) approves such busi n ess for the exemption and
issues a certificate number to the business. The business' number is required for the approval of the employed constractor's application.
Pl e ase complete the foll o wing items. If business has multiple use tax numbers, use 4. to identi f y the one that wil l be used to remit the tax under the Direct Pay Permit.
1.
2.
Name of Business (Please Print)
Name of County W here Facility is Located
Mailing Address
Physical Address
City
S tate
Zip Code
City
St ate
Zip Code
3. Trading As
:
Use Tax Number:
4.
(DBA)
Application is hereby made for permission to pay Mississippi Sales and Use Tax directly to the State Tax Commission on purchases in lieu of paying to the
vendor. Present the Direct Pay Permit Number to vendors when making purchases. Full responsibility is hereby assumed for the payment of ALL sales and
use tax on purchases, at the approriate rate of tax, EXCEPT for the tax due on the production of mineral and natural resource products, the tax due on utilities
used in manufacturing or processing and the contractor's tax due on taxable contracts while the permit is in effect. All sales and use tax due on purchases will
be paid under the use tax number and reported on the appropriate form.
Name of person signing (please print)
Signature
Mail To:
Mississippi State Tax Commission
Post Office Box 1033
Telephone Number
Title
Date
Jackson, Mississippi 39215

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