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E-589E

North Carolina Department of Revenue

Post Office Box 25000

8-09

Raleigh, North Carolina 27640-0001

Affidavit To Exempt Contractors

From the Additional 1% State Sales and Use Tax

To be used in connection with sales or purchases of building materials for use in the performance of lump

sum or unit price contracts entered into or awarded prior to September 1, 2009, or entered into or awarded

pursuant to bids made prior to September 1, 2009. This affidavit is to be executed by the contractors to

their suppliers of building materials and is valid only when used in connection with the Additional 1% State

sales and use tax.

This is to certify that _______________________________________________ , a contractor, entered into a lump sum

or unit price contract with _____________________________________________ on _________________ or pursuant

to a firm bid made on ___________________ whereby said contractor agreed to furnish the materials and labor for the

erection, alteration, or repair of a building or structure at __________________________________________________ .

This affidavit is submitted to ________________________________________________, a supplier of building materials,

for the completion of such lump sum or unit price contract without charging the Additional 1% State sales or use tax.

It is understood and agreed that the contractor will retain on file the original or duplicate original of said lump sum or unit price

contract for a period of not less than three years from the date this affidavit was executed for examination by an authorized

agent of the Secretary of Revenue of North Carolina with respect to the sales and use tax liability of the aforesaid building

contractor or supplier.

Contractor/Subcontractor

By:

Authorized Agent

Telephone Number

Title

Date

Instructions

1. This affidavit must be fully completed in all respects by a general contractor or a subcontractor who has entered into a

lump sum or unit price contract, or was awarded such contract pursuant to a bid made prior to September 1, 2009, for the

erecting, altering, or repairing of a building or structure. It must be submitted by such contractor to a supplier of building

materials as evidence of the holding of such lump sum or unit price contract.

2. The building materials supplier and the contractor should retain the affidavit on file for a period of not less than three

years.

3. The contractor must retain on file the original or duplicate original of the lump sum or unit price contract.

4. Purchase orders, invoices, shipping orders, delivery tickets, or any other pertinent records of the supplier and contractor

must be subject to examination as evidence of such facts.

Under the provisions of G.S. 105-236(7), any person who willfully attempts, or who aids or abets any person to attempt, in

any manner to evade or defeat any tax imposed by law, or the payment of the tax, is guilty of a Class H felony. For each

misuse of an exemption certificate, the Secretary must assess against the purchaser a penalty of $250.

Form E-589e - Affidavit To Exempt Contractors From The Additional 1% State Sales And Use Tax