340 4th Street Ewing, NJ 08638-2750
FORM VOID UNLESS COMPLETE INFORMATION IS SUPPLIED
Those purchasers set forth below may use this form in connection with the claim for exemption for the following taxes:
a. State and Local Sales and Use Tax;
b. PTA rental fee or tax on leases of motor vehicles;
c. Hotel Occupancy Tax if referenced with the symbol (•);
d. PTA fee on the purchase of tires if referenced with the symbol (+);
e. Vehicle Rental Tax (VRT)
Do not use this form for claiming an exemption on the registration of a vehicle. To claim an exemption from tax for a motor vehicle, trailer, semi-trailer or tractor with the PA Department of Transportation, Bureau of Motor Vehicles, use one of the following forms:
FORM MV-1 Application for Certificate of Title (first time registrations)
FORM MV-4ST Vehicle Sales and Use Tax Return/Application for Registration (other registrations)
Property and services purchased or leased using this certificate
from tax because: (Select the appropriate paragraph from this form,
check the corresponding block below and insert information requested.)
Exemption limited to purchase of tangible personal property or services for use and not for sale. The exemption shall not be used by a contractor performing
services to real property. An exempt organization or institution shall have an exemption number assigned by the PA Department of Revenue and diplomats shall
have an identification card assigned by the Federal Government. The exemption for categories "A, B, C and D" are not valid for
property used for the following:
(1) construction, improvement, repair or maintenance or any real property, except supplies and materials used for routine repair or maintenance of the real
property; (2) any unrelated activities or operation of a public trade or business; or (3) equipment used to maintain real property.
Property or services will be used directly and predominately by purchaser performing a public utility service.
This Exemption is not valid for property or services used for the following: (1) construction, improvement, repair or maintenance of real property, other than real property which is used directly in rendering the public utility services; or (2) managerial, administrative, supervisor, sales or other nonoperational activities; or (3) tools and equipment used but not installed in maintenance of facilities or direct use equipment. Tools and equipment used to repair "direct use" property are exempt from tax.
Vendor/Seller purchasing wrapping supplies and nonreturnable containers used to wrap property which is sold to others.
I am authorized to execute this Certificate and claim this exemption. Misuse of this Certificate by seller, lessor, buyer, lessee, or their representative is punishable by fine and imprisonment.