St-109a - Equipment List - Sales & Use Tax Information
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2Equipment List - Sales & Use Tax Information
ST-109A
South Dakota Department of Revenue
Revised 03/16
445 E. Capitol Ave | Pierre, SD 57501-3185 | 1-800-829-9188
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State Use
City Use
Tax
Tax
Present Fair
Type of Equipment
Year
Purchase
Tax Paid on
Market Value
and Serial Number
Mfg.
Price
Purchase
4.5%
___%
TAX DUE
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Serial No.:
Contractor Name:__________________________________________________________________________
Address:_________________________________________________________________________________
Contractor’s Excise Tax License:______________________________________________________________
Project:__________________________________________________________________________________
Date:
Signed:
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Parent category: Financial