Form 51a402 - Vendor Assignment Agreement For Sales At A Qualifying Public Facility printable pdf download

Form 51a402 - Vendor Assignment Agreement For Sales At A Qualifying Public Facility

51A402 (6-10)

Commonwealth of Kentucky

DEPARTMENT OF REVENUE

VENDOR ASSIGNMENT AGREEMENT FOR SALES

AT A QUALIFYING PUBLIC FACILITY

The undersigned vendor is the holder of Kentucky Sales and Use Tax Account Number ____________,

which is used to report the vendor’s receipts and applicable Kentucky sales tax from sales of admissions to, or

tangible personal property at, the public facility identiﬁ ed as ______________________________________.

In consideration of its ability to conduct sales on the premises of the public facility, the undersigned agrees

to fully cooperate with the governmental entity that owns and operates the public facility and the Department of

Revenue (DOR) to facilitate the sales tax rebate process provided in KRS 139.533. The vendor further agrees to

provide the approved governmental entity or DOR with copies of its sales tax returns, other ﬁ nancial statements,

or any other documents necessary to support the sales tax rebate request for a refund of sales tax collected and

remitted on qualifying public facility sales of admissions or tangible personal property. If the vendor reports

sales from all Kentucky sales on a consolidated return, the vendor is required to separately identify the sales

locations and separately identify the gross receipts and sales tax generated from the public facility.

The vendor also assigns any and all sales tax rebates payable to the governmental entity that owns and

operates the public facility pursuant to KRS 139.533, and its rights, title and interest in any such rebates. In

addition, the vendor waives any claim or protest in connection with such rebates. The vendor, governmental

entity, and DOR rely on this assignment in taking any actions it deems necessary or appropriate in paying the

sales tax rebate pursuant to KRS 139.533.

Dated this _________ day of _____________________ , 2____ .

Vendor: ____________________________________________

By: ________________________________________________

Title: ______________________________________________

Notarized by:

__________________________________________________

Form 51a402 - Vendor Assignment Agreement For Sales At A Qualifying Public Facility