Utah State Sales Tax Exemption Form
ADVERTISEMENT
1Jan.
12. 201Lll:36AM,
_
(i)
Utah State Tax
Commission
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IRta
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H,
our
1m 1ft
or
•• , c
I
ental Tu)
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TC·721
Rev, 1/10
Clly
Nama
of
bu4ineGa
01'
Institutionclllmlrlll_mpt!on
(pu~.r)
Slreet
Add~ss
Name (Pleaae print)
Dels
Th. ptl'lOn algnlng thla
certificate
MUST
.check the
applicable
box ahowlnglht
b •• la for
'whlch the axemptlon
I.
being claimed.
Que,tlc,,'
Ihould be directed
'(preferablv
In
writing)
to
TaxpayerServlcu,
Utah
Stat. Tax Commission, 210 N 1850
W.
Silt Lake
CIty,
VT
14134.
Telephone (S01) 287.2200, or toll
"H
1-800-GS2-4335.
DO NOT
SEND
THIS
CERTIFICATE
.TO THE TAX COMMISSION
.
.
;
Keep it with your
records
in case of an
audit.
,
.
For purchase,
by
government,
Natlv. American tribes and public IIchoola,
Us,
form
TC·721
G.
o
RESALE OR RE-L.EASE
SalelTax
Wean.e
No.
_
I CQl1lfy
I
am
a
dealer in tangible personal property or services that
Is fer resale or re-Iea$e. If I use or consume any tangible personal
property or servlcaa I purchase tax free for resale, or If my sales are
of
food,
beveragas,
dairy
products
and
similar
confections
dispensed from vending machines (see Rule
R86~-19S·74),
I Will
report and
pay
sales tax directly to the
'Tlax
Commission
en
my
next
sal8$ and use
tax
return.
o
LEASE BACKS
I
certify the tenglble personal property leased sati&fies the following
conditions; (1) the property Is part of a sale-leaseback transac!lon; (2)
sale& or use tax was paid on the Initial purchase of the property; end,
(3) the leased property will be capitalized and the lease paymen1s will
be accounted lor as payments made under
Ii
financing arrangement,
o
AGRICULTURAL
PRODUCER
I certify the Items purchased
will
be used primarily and dlrec1~ In a
commercial farming operation and
qualify
for the
Utah
sales
and
use
tax exemption.
o
COMM!ACIAL.
A1RUNES
I cenlfy the food and beverages purchased
are by
a
commercial
airline for in-flight
consumption;
or. any parts
or equipment
purchased are for use In aircraft operated by common carriers In
Interatate or foreign commerce,
COMMERCIALS,
FILMS, AUDIO AND VIDEO TAPES
SeiliTax Llcenle
No.
_
I certify that purchases
of commercials,
films, prerecorded video
tapes, prerecorded
audlo program tapes
or
records are for sale or
distribution to motion ple!ure exhibitors. or commercial television or
radio broadcasters.
If I subsequently
resell
items
to
any other
customer, or use or consume any of these Items, I will report any
tax
liability directly to the Tax Commission.
o
o
FILM, T!~VISION,
VID!O
.
I cenlfy that purchasea. leasea or rentals of machinery
or 9Qulp.
ment
will be used by a motion picture or video production company
for
the
production
01
media fer oommercial
dlstrlbution.
POLLUTION
CONTROL. FACIUTY
SeluTax
Ucan" No.
,.---
I certify our company has been granted a ·Certlflcation
or Pollution
Control Faolll~es' as provided for
by
Utah Cod.
§§19-2-123
through
'19-2-127
and
as
explained in
laX
Commll55lon Rul.
RSSS-1eS·83
by
either the Air Quality
Soard
or the Water Quality Board. I further
certify each
item
of
tangible personal property purchued
undor this
.exemption
Is
qualifying machinery or eCluipment for this purpose,
o
o
MEDICAL
EQUIPMENT
I certify the equipment or device checked below IS prescribed by a
licensed physician for human ulla.
o
Durable Medica! Equipment primarily used to serve a medical
purpose,
Is not worn in or on the body, and
Is
for home use
only.
(Sales of spae and saunas are taxable.)
o
Mobility
Enhancing
equipment
primarily
used to Improve
movement,
Is
for use in
a
home or motor
vehIcle,
and Is not
used by persons with normal
mobility,
o
Prosthetlc
Device used to replace
a
missing body part. to
prevent or correct
a
physical
deformity,
or support
Ii
weak
body
part, This Is also ~empt
If
purchased
by a hospital cr
medical
facility,
(Sales
01
corrective eyeglasses
and contae!
lenses are taxable,)
o
Disposable
Home
Medical
Equipment
or
Supplies
that
cannot withstand repeated use and purchased by. for, or on
behalf of a person other than a health care facility, health care
provider or office of
a
health care provider. The equipment
and supplies must be eligible for payment under Title XVIII,
federal
Social Security Act, or the state plan for medical
ssal91ance under Title
XIX.
faoeral Social Security Act.
o
OUT·DF·STATE
CONSTRUCTION
MATERIALS
I certify this tangible personal property will be shipped out of state
and will become part
01
real property located In a state that does not
have a sales tax or allow credit
lor
tax paid to utah.
o
CONSTRUCTION
MATERIALS
PURCHASED
FOR AIAPORTS
I certify the construction
materials
are
for a new airport owned or
operat.d
by a c1ty
In
Cavls, Utah, WashIngton
or Weber
County.
I
further
certify
the constructron
materials
will be Installed
or
converted Into real property ownad
by
end located at the airport.
D
CONSTRUCTION
MATEAIALS
PURCHASED
FOR REUGIOUS
AND CHARITABL!
OAGANlZATlONS
I certify the construction
materials purchased
are
on
behall
01
a
religious or cI'Ilrltabie
organization.
Ifurther certify the purchased
construction
materials
will be Installed
or converted
Into real
property owned
by
the religiOUS or charitable organization.
Name of religious or charitable organization:
Salel
Tax Exemption No.
Name
01
project;
-e-t-
_
D
DIRECT MAIl.
SI'" Tax Uo." •• No. __
--:--:---:---::---::---:-:--
I oertify
I
will repon and pay the 511es .tax for direct mall purchases
on my next Utah S8185 and Use 7I!Ix
Return.
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