Form St-28b - 2015 Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter
Download a blank fillable Form St-28b - 2015 Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form St-28b - 2015 Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2KANSAS DEPARTMENT OF REVENUE
STATEMENT FOR SALES TAX EXEMPTION ON ELECTRICITY, GAS, OR
WATER FURNISHED THROUGH ONE METER
Please type or print this form and send a completed copy WITH worksheets to your utility company. Complete a form for each meter on
which you are applying for an exemption.
1.
___________________________________________________
_______________________________________________
Address of meter location
Utility account number
2. In accordance with the Kansas Retailers’ Sales Tax Act, the undersigned purchaser states that the (circle one: electricity, gas, water)
sold and furnished by (name of utility company)
___________________________________________________________
through
meter number
________________________
at the above location issued for the following purposes based on annual consumption.
3.
__________________________________________________ uses electricity, gas or water for the following purpose (check one):
PURCHASER (Name of individual, company, or organization)
What is a general description
of how the service is used?
Unless otherwise indicated, the uses below are exempt from state and local sales tax.
‰
‰
Agricultural use.
Severing of oil.
(Electricity & gas subject to local sales tax.)
‰
‰
Ingredient or component part.
Certain nonprofit corporations exempt from real estate
‰
property tax – i.e., adult care homes (nursing homes);
Irrigation of crops.
‰
private children’s homes (nursing home foster care, etc.);
Movement in interstate commerce by railroad or public utility.
‰
housing for low and limited income elderly and disabled
*Noncommercial educational radio or TV station.
persons (includes HUD housing projects); housing for the
‰
Noncommercial residential use.
(Electricity & gas subject
elderly; and group housing for mentally ill, retarded, and
to local sales tax.)
other disabled persons.
A
“
”
‰
TTACH A COPY OF THE
ORDER
FROM THE
*Nonprofit hospital.
B
T
A
.
‰
OARD OF
AX
PPEALS
*Nonprofit museum or historical society.
‰
Consumed in the production, manufacturing, processing,
‰
*Nonprofit zoo.
mining, drilling, refining, or compounding of tangible
‰
*Over-the-air free access radio or TV station. Only the
personal property, or treatment of by-products or wastes
electricity used to produce the broadcast signal is exempt.
of any above processes.
All other utility use is taxable.
‰
Domestic violence shelters.
‰
Providing taxable services.
‰
*Educational institutions and nonprofit trusts, nonprofit
‰
*Religious organization exempt from federal taxation
endowment associations and foundations operated for the
under section 501(c)(3) of the federal Internal Revenue
sole benefit of an education institution.
Code.
‰
*Government entity.
‰
*Other exempt entity
Enter Sales Tax Exemption Identification Number _________________________________ Employer ID Number (EIN) _______________________________
*
4. Type of business ___________________________________________________________________________________
5. Describe the taxable service; movement in interstate commerce; agricultural use; or property produced, manufactured, etc.
_____________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________
NOTE: Sales of water to residential premises for noncommercial use or for agricultural use are NOT subject to local (city/county)
sales tax. However, all electricity and gas used to light, heat, cool, clean or maintain equipment, buildings or business facilities
(offices, plants, shops, warehouses) are FULLY TAXABLE.
This includes, but is not limited to, electricity and gas for air
conditioners, all lighting (including production area), exhaust fans, freezers, heaters, refrigerators, other appliances and machines.
6. EXEMPT PERCENT
___________
% (See instructions.)
The undersigned purchaser agrees and certifies that: a) this statement is true, correct, and complete; b) the worksheets used to
determine the “Exempt Percent” will be kept by the undersigned and copies of the worksheets and this completed form will be
provided to the utility company); and, c) in the event there is a change in the “Exempt Percent”, a revised statement will be filed
immediately with the utility company. If the electricity, gas, or water exempted from taxation is determined to be taxable at a rate other than
stated above, the undersigned purchaser agrees to reimburse the utility company or KDOR for any amounts assessed as retailers’
sales or compensating tax, penalties, and/or interest.
Purchaser: _______________________________________________________
Phone No. _____________________________
Individual, company, or organization name
Address: ___________________________________________________________________________________________________
Street, RR, or P.O. Box, City, State, Zip + 4
Email Address
___________________________________________________________________________ Date: _______________________
Printed Name
*Authorized Signature
ST-28B (Rev. 4/15)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Bt/st-28b - Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter
Financial
Form St-28b - Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter - State Of Kansas
Financial
Form St-28b - Statement For Sales Tax Exemption On Electricity, Gas, Or Water Furnished Through One Meter
Financial
Related Categories
Parent category: Financial