Form Dr 0172 - Contractor Application For Exemption Certificate (Page 2 of 2) in pdf

Form Dr 0172 - Contractor Application For Exemption Certificate Page 2

Special Notice

Contractors who have completed this application in the past, please note the following changes in procedure:

The Department will no longer issue individual Certificates of exemption to subcontractors. Only prime contrac-

tors will receive a Contractor's Exemption Certificate on exempt projects.

Upon receipt of the Certificate, the prime contractor should make a copy for each subcontractor involved in the

project and complete it by filling in the subcontractor's name and address and signing it.

The original Certificate should always be retained by the prime contractor. Copies of all Certificates that the

prime contractor issued to subcontractors should be kept at the prime contractor's place of business for a

minimum of three years and be available for inspection in the event of an audit.

Once an 89# has been assigned to you, please use the next five numbers following it for any applications

submitted for future projects. This should be your permanent number. For instance, if you were assigned 89-

12345-0001, every application submitted thereafter should contain 89-12345 on the application. The succeed-

ing numbers will be issued by the Department of Revenue. DO NOT enter what you believe to be the next in

sequence as this may delay processing of your application.

Form Dr 0172 - Contractor Application For Exemption Certificate Page 2