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Pennsylvania Tax Exemption Form

FORM VOID UNLESS COMPLETE INFORMATION IS SUPPLIED



GENERAL INSTRUCTIONS

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)

NOTE:

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 are exempt from tax because:
(Select the appropriate paragraph from this form, check the corresponding block below and insert information requested.)

This exemption is not valid for property or services which are used in: (a) constructing, repairing, or remodeling of real property, other than real property which is used directly in exempt operations; or (b) maintenance, managerial, administrative, supervisory, sales, delivery, warehousing or other nonoperational activities. Effective October 1, 1991, this exemption does not apply to certain services and PTA tire fee.

This exemption is not valid for property or services which are used in: (a) constructing, repairing, or remodeling of real property, other than real property which is used directly in exempt operations; or (b) maintenance, managerial, administrative, supervisory, sales, delivery, warehousing or other nonoperational activities. Effective October 1, 1991, this exemption does not apply to certain services and PTA tire fee.
*Exemption not valid for registered vehicles
**This Exemption Certificate is limited to the purchase of parts, repairs or maintenance services upon vehicles licensed as school buses by the PA Department of Transportation. For purchase of school buses, see NOTE below.

If purchaser does not have a PA Sales Tax License Number, include a statement under Number 7 explaining why a number is not required.

Property and/or services will be resold or rented in the ordinary course of purchaser's business. If purchaser does not have a PA Sales Tax License Number, complete Number 7 explaining why such number is not required. This Exemption is valid for property or services to be resold: (1) in original form; or (2) as an ingredient or component of other property.

Renewable Entities beginning with the two numbers 75:
A. Religious Organization
B. Volunteer Firemen's Organization
C. Nonprofit Educational Institution
D. Charitable Organization
Permanent Exemptions beginning with the two numbers 76:
E. School District
Special Exemptions:
F. Direct Pay Permit Holder
+ • G. Individual Holding Diplomatic ID
H. Keystone Opportunity Zone
I. Tourist Promotion Agency

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.

and/or


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.


If purchaser does not have a PA Sales Tax License Number, include a statement under Number 7 explaining why a number is not required.

Vendor/Seller purchasing wrapping supplies and nonreturnable containers used to wrap property which is sold to others.


Please explain in detail.

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.