Form Cot/cd-206 - Exemption Certification For Utilities Or Fuel Used In Production Activities
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1
2State of Maryland
Comptroller of Maryland
Compliance Division
301 West Preston Street
Baltimore, MD 21201-2383
Exemption Certification for Utilities or
Fuel Used in Production Activities
Instructions
A. This form is to be used to claim from suppliers the sales and use tax exemption for utilities consumed in a
production activity. The completed form is to be provided to the supplier and not to the Compliance Division.
B. This form is not to be used to claim a resale exclusion or exemption other than the production activities exclusion.
C. This form is not to be used to claim exemption for purchases other than those of gas, electricity, steam, oil or coal.
D. Purchases of utilities and fuel by retail food vendors for use in processing food for sale are not eligible for
exemption.
Supplier:
_________________________________________________________________________________________________
Name
_________________________________________________________________________________________________
Street Address
_________________________________________________________________________________________________
City or town, state & ZIP
Buyer:
_________________________________________________________________________________________________
Name
Sales and use tax registration number
_________________________________________________________________________________________________
Street address
_________________________________________________________________________________________________
City or town, state & ZIP
Type of utility fuel (Check appropriate box):
Gas
Electricity
Steam
Oil
Coal
If applicable, enter:
_________________________________________________________________________________________________
Service location
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Meter number(s)
Utility account number
Describe the purpose to which the utilities or fuel are being used, specifying the products produced:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
I HEREBY CERTIFY under penalties of perjury that the above described utilities or fuel will be consumed directly and predominantly
within the meaning of Regulation .10 (See reverse side of this form for pertinent provisions of Regulation .10.) I understand that
purchases of utilities and fuel by retail food venders for use in processing food for sale are not eligible for exemption.
_________________________________________
_________________________________________
Signature
Print name
_________________________________________
_________________________________________
Date
Telephone number
Title
COT/CD-206 (Rev. 8/04)
For the hearing impaired • MRS 1-800-735-2258 • TDD (410) 767-1967 • EOE
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