Clear Form
FORM
G-37
(REV. 2015)
STATE OF HAWAII — DEPARTMENT OF TAXATION
General Excise/Use Tax Exemption For Certified or
Approved Housing Projects
(Section 46-15.1 or 201H-36, HRS)
Name of individual, trust, estate, partnership, association, company, or corporation Hawaii Tax Identification No.
W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
Name under which business is operated
Type of Business/Service
Please
Business address (Number and Street)
Contract Amount
Type
$
City, Island
Postal / Zip Code
GET/Use Tax exemption amount
Or
$
Print
Project Name
Contract Number
Contract Effective Date
Project Address
Tax Map Key Number
The entity indicated above is contractually participating (Check the appropriate blocks to complete this sentence.)
in the (check applicable)
being developed by a (check one)
pursuant to (check one)
planning
construction
non-profit entity
Section 46-15.1, HRS.
design
sale
limited distribution mortgagor
Section 201H-36, HRS.
financing
rental of
private developer
affordable units
public agency
The entity indicated above will import property, services, or contracting from the unlicensed sellers identified in Schedule A for use
specifically related to the above-named project. The landed value of the imported property, services, or contracting is $_______________
and is excluded from the imposition of the use tax pursuant to section 238-3(j), HRS. (Attach Schedule A.)
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ DECLARATION ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
I declare under the penalties set forth in section 231-36, HRS, that this exemption and attached schedules, if any, are prepared in accordance with the
provisions of section 46-15.1 or 201H-36, HRS, and the rules issued thereunder. It is further understood that the misuse of this exemption will lead to its
revocation and/or the imposition of penalties provided by law.
Signature of Taxpayer or Authorized Agent
Contact Phone Number
Date
Type or Print Name
Type or Print Title
)
(Owner, Partner or Member, Officer, or Duly Authorized Agent
See the reverse side for filing instructions
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ CERTIFICATION~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
This is to certify that the entity indicated above is contractually participating in the above mentioned project.
Certified
Signature of Certifying Officer
Date
(Type or Print Name and Title)
(Name of Certifying County or State Agency)
FORM G-37