Fillable Form Tc-721 - Exemption Certificate printable pdf download

Utah State Tax Commission • 210 N 1950 W • Salt Lake City, UT 84137

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TC-721

Exemption Certificate

Rev. 11/17

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(Sales, Use, Tourism and Motor Vehicle Rental Tax)

Name of business or institution claiming exemption (purchaser)

Telephone number

Street address

City

State

ZIP Code

Authorized signature

Name (please print)

Title

Date

Name of Seller or Supplier:

Sales Tax License Number:

Required for all exemptions marked with an asterisk (*)

The signer of this certificate MUST check the box showing the basis for which the exemption is being claimed.

DO NOT SEND THIS CERTIFICATE TO THE TAX COMMISSION

Keep it with your records in case of an audit.

For purchases by government, Native American tribes and public schools, use form TC-721G.



Refinery Machinery, Equipment and

Resale or Re-lease

I certify I am a dealer in tangible personal property or services that

Normal Repair or Replacement Parts

are for resale or re-lease. If I use or consume any tangible personal

I certify the machinery, equipment, normal operating repair parts,

property or services I purchase tax free for resale, or if my sales are

catalysts, chemicals, reagents, solutions or supplies are for the use

of food, beverages, dairy products and similar confections

of a refiner who owns, leases, controls or supervises a refinery (see

dispensed from vending machines (see Rule R865-19S-74), I will

Utah Code §63M-4-701) located in Utah.

report and pay sales tax directly to the Tax Commission on my next

sales and use tax return.



Auto, Industrial Gas, or

Drilling Equipment Manufacturer



Religious or Charitable Institution

I certify the machinery, equipment, normal operating or replace-

I certify the tangible personal property or services purchased will be

ment parts are used or consumed in a manufacturing process as

used or consumed for essential religious or charitable purposes.

described in NAICS 336111 (Automotive Manufacturing), or

This exemption can only be used on purchases totaling $1,000

325120 (Industrial Gas Manufacturing) to manufacture hydrogen of

or more, unless the sale is pursuant to a contract between the

the 2002 North American Industry Classifications Systems, or by a

seller and purchaser.

drilling equipment manufacturer as defined in Utah Code

§59-12-102.



Construction Materials Purchased for



Religious and Charitable Organizations

Pollution Control Facility

I certify the construction materials are purchased on behalf of a religious

I certify our company has been granted a “Certification of Pollution

or charitable organization and that they will be installed or converted into

Control Facilities” as provided for by Utah Code §§19-12-101 -

real property owned by the religious or charitable organization.

19-12-305 by either the Air Quality Board or the Water Quality

Name of religious or charitable organization:

Board. I further certify each item of tangible personal property

purchased under this exemption is qualifying.

______ __________ ____________ ____

Name of project: _________ _____ _____ _ ___



Steel Mill



I certify the rolls, rollers, refractory brick, electric motors or other

Machinery and Equipment and Normal Operating

replacement parts will be used in the furnaces, mills or ovens of a

Repair or Replacement Parts Used in a Manufacturing

steel mill as described in Standard Industrial Classification (SIC)

Facility, Mining Activity or Web Search Portal or

3312.

Electronic Payment Service



Municipal Energy

I certify the machinery and equipment and normal operating repair

or replacement parts have an economic life of three years or more

I certify the natural gas or electricity purchased: is for resale; is

and are for use in a Utah manufacturing facility described in SIC

prohibited from taxation by federal law, the U.S. Constitution, or the

Codes 2000-3999; in a qualifying scrap recycling operation; in a

Utah Constitution; is for use in compounding or producing taxable

co-generation facility placed in service on or after May 1, 2006; in the

energy; is subject to tax under the Motor and Special Fuel Tax Act;

operation of a Web search portal by a new or expanding business

is used for a purpose other than as a fuel; is used by an entity

described in NAICS Code 518112 between July 1, 2010 and June

exempted by municipal ordinance; or is for use outside a municipali-

30, 2014; in the operation of an electronic financial payment service

ty imposing a municipal energy sales and use tax. The normal sales

described in NAICS Code 522320; or in a business described in

tax exemptions under Utah Code §59-12-104 do not apply to the

NAICS 212, Mining (except Oil and Gas), or NAICS 213113,

Municipal Energy Sales and Use Tax.

Support Activities for Coal Mining, NAICS 213114, Support Activi-



ties for Metal Mining, or NAICS 213115, Support Activities for

Short-term Lodging Consumables

Nonmetallic Minerals (except Fuels) Mining. For a definition of

I certify the tangible personal property is consumable items

exempt mining equipment, see Utah Code §59-12-104(14).

purchased by a lodging provider as described in Utah Code

§59-12-103(1)(i).



Fuels, Gas, Electricity



I certify all natural gas, electricity, coal, coke, and other fuel

Direct Mail

purchased will be used for industrial use only and not for residential

I certify I will report and pay the sales tax for direct mail purchases

or commercial purposes.

on my next Utah Sales and Use Tax Return.

IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.

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Form Tc-721 - Exemption Certificate

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