Affidavit Of Non Taxable Sale To Tax-Exempt Organization Form

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Affidavit of Non-Taxable Sale to Tax-Exempt Organization
The undersigned declares, under penalties of perjury, that the tangible personal property or taxable service purchased without payment of
otherwise applicable Colorado sales tax(es) from
Vail Cascade Resort and Spa
1300 Westhaven Drive, Vail, CO 81657
is to be paid from the tax-exempt organization's funds and that said organization has not and will not receive any reimbursement through
either direct payment, collection or "donation" from any person(s) for the use or consumption of said tangible person property or service.
Please check the true statements below. ALL must be true for the purchase to qualify for exemption.
The organization is a religious, charitable, educational or governmental entity that has been granted tax exempt status.
Payment is made from the organization’s funds and no reimbursement will be made to the organization through direct payment, collection or donation
from any person(s) for the use or consumption of the goods or services;
The items or services purchased are used in conjunction with the organization’s regular religious, charitable, educational or governmental activities.
Basis of Exemption:
____ Religious
____ Charitable
____ Governmental
Please attach a copy of the Exemption Certificate
Customer Name:
Reservation or Group #
Arrival Date
Departure Date
Tax Exempt Organization/Agency Name:
DL State and Last 4 Digits
Colorado Tax ID Number or FEIN
Customer Address:
Sales Tax Exemption #
Phone #
City
State
ZIP Code
Source of Payment
Check from Tax-Exempt Organization's bank account with Organizations name on the check
Credit card in the name of and billed directly to the Tax-Exempt Organization
(Please complete the attached Credit Card Authorization form if the credit card will not be presented at the time of purchase.)
*Please complete if paying by Government Credit Card.
Affidavit of Sales Paid by Governemnt Credit Card (DR 1367)
·
I affirm that this purchase qualifies for the Colorado sales tax exemption for sales to the United States government, the State of Colorado, its departments and institutions, and
its political subdivisions (county and local governments, school districts and special districts); is a government purchase used only in an official governmental capacity; and will be paid
directly by a government agency.
·
I have checked the applicable boxes below regarding information about payment for this purchase.
·
I accept that I remain directly liable for the sales or use tax assessment, and any applicable penalty or interest, if my purchase is found to not qualify for the
exemption.
·
I understand that the vendor may request this affidavit for every purchase.
Check all that apply. For further information visit the Dept of Rev website at for more information
The agency exemption number is printed on the card. The number is 98 or 098-_______________
The card is a State/Central Travel Card. The State card has the State seal and the words “Tax Exempt” on it
The card is a Purchasing Card. The federal version has a picture of the U.S. Capitol. The state card has “Commercial” or “Purchasing” printed on it.
The card has an 8 digit exemption number below the cardholders name. The number is_______________________
The card is an Integrated Card (w/picture of the U.S. flag) or a Travel Card(w/picture of an airplane) And the sixth digit of the card is 0,6,7,8, or 9.
The card is a Department of the Interior Mastercard issued by Bank of America w/acct beginning 5568-16.
The card is not Bureau of Land Management or National Park Services (Department of Interior).
The card State Department issued with the name/photo of the bearer and an image of an animal native to North America on the card.
Name
Title
Signature
Date
Please attach a copy of the Exemption Certificate
If a dispute arises between the vendor and the organization as to whether a sale is taxable, state law requires the vendor to charge the tax and the purchasing
organization to pay it. [§39-26-102 (22), C.R.S.] The organization may file a “Claim for Refund” (DR 0137), which is available upon request from the
Department of Revenue, or on the Web at within 60 days of purchase.

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