Form A-006 - Affidavit Of Exempt Sales - Wisconsin Department Of Revenue
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State of Wisconsin
DEPARTMENT OF REVENUE
l
NEXUS UNIT l 2135 RIMROCK RD l MAIL STOP 5-257 l PO BOX 8906 l MADISON, WI 53708-8906 l FAX (608) 261-4902 l WEB SITE:
Affidavit of Exempt Sales
2003 Wisconsin Act 33 created a provision requiring the Secretary of Revenue to determine and periodically certify to the
Secretary of Administration the names of persons and their affiliates, who make sales of tangible personal property or taxable
services that are subject to Wisconsin sales or use tax, but who are not registered with the department to collect and remit
such taxes, or if registered, do not collect and remit such taxes. The Department of Administration and certain designated pur-
chasing agents, agencies, and authorities may not contract for the purchase of materials, supplies, equipment, or contractual
services with a person or its affiliate who has been certified by the Secretary of Revenue as described above.
“Affiliate” means a person, as defined in sec. 77.51(10), Wis. Stats., that controls, is controlled by, or is under common con-
trol with another person. “Control” means to own, directly or indirectly, more than 10% of the interest in or voting securities
of a business.
Any business that only makes sales that are not subject to sales or use tax under ch. 77, Wis. Stats., may complete the af-
fidavit below. This is certification that all sales the business makes in Wisconsin are exempt from the Wisconsin sales and
use tax. Examples of exempt sales are sales for resale, sales to governmental units, sales to exempt organizations and
sales of non-taxable services. Exempt sales do not include sales of tangible personal property or taxable services on which
a retailer does not collect tax solely because it does not have nexus with Wisconsin. Any business having only exempt sales
will not be required to register for the collection of Wisconsin sales or use tax. Chapter 77, Wis. Stats., may be accessed at
Legal name
Business name (DBA)
Mailing address
Federal ID number
Type of property sold
Type of services sold
certifies that all Wisconsin sales of its property and ser-
Company Name
vices are exempt under ch. 77, Wis. Stats.
I certify that, to the best of my knowledge, the above information is accurate and complete.
Completed by (please type or print)
Title
Signature
Date
Telephone Number
Fax Number
** THIS FORM MAY BE REPRODUCED **
A-006 (R. 2-11)
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