Form Dr 1666 - Sales Tax Exempt Certificate Electricity And Gas For Industrial Use
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1DR 1666 (04/01)
COLORADO DEPARTMENT OF REVENUE
1375 SHERMAN
DENVER CO 80261
SALES TAX EXEMPT
CERTIFICATE
ELECTRICITY & GAS
FOR INDUSTRIAL USE
NOTE:
If your company is 75% or more exempt from sales taxes, file this form with your utility company. The utility company
will cease charging state and RTD/CD/FD sales taxes and state collected local taxes. If your business is less than
75% exempt, see the instructions below.
SUPPLIERS AND ACCOUNT INFORMATION (Complete a separate form for gas and for electricity)
Department of
Revenue
Utility Supplier: Name and Address (street, city/town, state)
Service Location
% for Exempt Usage
Account Number
APPLICANT
Name of Applicant (name and address as shown exactly on the utility billing)
Telephone Number
Street Address or P.O. Box Number
City
State
ZIP
(Complete a separate
Utility Account Number
Gas
Electricity
form for each)
For the purpose of this exemption, the term "industrial use" has the following meaning: the use of gas or electricity in a continuing
business activity of manufacturing or producing tangible personal property or services.
The following uses do not qualify for the exemption: electricity and or gas used in offices, lunch rooms, laboratories, maintenance
rooms, computer rooms, lounges and waiting areas, and usage solely for the comfort of employees. Also, usage prior to or
subsequent to the actual exempt activity performed.
You must determine the percentage of exemption for each meter, either by using square footage for exempt and non-exempt usage
or by determining the actual energy consumption of exempt usage. Keep a copy of your computations with your records and submit
a copy to the Department of Revenue with any claim for refund of taxes paid.
If usage is more than 75% exempt submit this Certificate to your utility supplier and it will not add tax to your utility billings. If less
than 100% exempt, you must remit tax on the non-exempt portion. If usage is less than 75% exempt, do not submit this form to your
utility supplier, but continue to pay tax on your utility bills and, in January of each year, submit a claim for refund of the tax paid on
the exempt portion.
Refer to FYI Sales 71, "Sales Tax Exemption on Commercial Utility Usage."
Under penalty of perjury, I swear or affirm that the gas and/or electric service which is billed to the above applicant under a commercial
rate by the supplier named herein is used for industrial use and therefore qualifies for exemption under 39-26-102(21) C.R.S.
Authorized Signature (owner, partner or corporate officer)
Telephone Number
Title
Date
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