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HomeMy WebLinkAboutTax Exempt CertificateNew York State and Local Sales and Use Tax Exempt Organization Certification ST-119.1 This certification is not valid unless all entries have been completed. Name of seller NYS ~ndor ID number Name of exempt organization making purchases Mailing address Mailing address City, village or post office City, village or post office State ZIP code State ZIP code I certify that the organization named above holds a valid Form ST-119, Exempt Organization Certificate, and is exempt from state and local sales and compensating use taxes on its purchases. (6/93) Enter exempt organization number from Form ST-119 A163554 Si~rm~Jre of officer qf~r~a~zation Title Date prepared Supervisor, Town of Southold Instructions Seller If all entries have been completed and an officer of the organization has signed the certification, you may accept it to exempt sales to the organization named. The exempt organization must be the direct pumhaser and payer of record. Any bill, invoice or receipt you provide must show the organization as the purchaser. Payment must be from the funds of the exempt organization. This form may not be used to claim exemption for the following: -- the pumhase of motor fuel or diesel motor fuel including No. 2 heating oil (see Purchaser section) -- the ten-cents-per quart tax on the retail sale of lubricating oil. This tax is imposed on the retail seller and included in the price charged the purchaser. -- the special fee on paging serVmes unless the purchaser is a volunteer fire or ambulance company that has been granted exemption from sales and use tax pumuant to section 1116(aX4) of the tax law. To claim this exemption, the exempt voluntary fire or ambulance company must supply the paging service with this form and a letter that identifies the exempt organization and states that it is exempt from the special fee on paging devices because it is a volunteer fire or ambulance company (see Notice N~92-17 for additional information.) The exempt organization must give you certification at the time of the organization's first purchase. A separate document is not necessary for each subsequent purchase, provided that the exempt organization's name, address, and certificate number appear on the sales slip or billing invoice. The certification is constdemd part of each order and remains in force unless revoked. If a certification with all entries completed ia not received within 90 days after the delivery of the property or service, you will sham with the pumhaser the burden of proving the sale was exempt. You must keep this Exempt Organization Certification for at least three years after the date of the last exempt sale substantiated by the certification. Purchaser Complete this certification and give it to the seller. You may get additional copies of Form ST-119.1 at any district tax office or by writing to the NYS Tax Department, Taxpayer Assistance Bureau, W A Harriman Campus, Albany NY 12227. This form may be reproduced without prior permission from the Tax Department. Your exemption from New York State and local sales and use tax does not extend to officers, members or employees of the exempt organization. Personal pumhaees made by these individuals are subject to sales and use tax. An organization's exemption does not extend to its subordinate or affiliated units. When making pumhases, subordinate units may not use the exemption number assigned to the parent organization. Such misuse may result in the revocation of the pamot organization's exemption. You may not use this form to make tax exempt pumhases of motor fuel, diesel motor fuel, lubricating oil and, if you are not a voluntary fire or ambulance company, to avoid the special fee on paging devices. Since No. 2 heating oil falls within the definition of diesel motor fuel; you may not use this form to purchase it tax exempt. You must use Form FT-1020, Exemption Certificate for Certain Taxes Imposed on Diesel Motor Fuel and Propane or Form FT-1025, Certificate for Exemption from Certain Taxes Imposed on Diesel Motor Fuel, to claim exemption on heating oil. Hospitals that have been granted an exemption from sales and use tax pursuant to section 1116(a)(4) of the Tax Law may claim exemption on the pumhase of motor fuel by using Form FT-937, Certificate of Sales Tax and Motor Fuel Tax Exemption for Qualified Hospitals. Substantial civil and/or criminal penalties will result from the misuse of this form. ~ ~ sm. New York State and Local Sales and Use Tax ' Exempt Organization Certification This certification is not valid }]nless all entries have been completed. ST-119.1 (6/93) I certify that the organization named above holds a valid Form ST-119, Exempt Organization Certificate, and is exempt from state and local sales and compensating use taxes on its purchases. Signature of officer of organizaion T~tle I Date prepared Instructions Seller If all entries have been completed and an officer of the organization has signed the certification, you may accept it to exempt sales to the organization named. The exempt organization must be the direct pumhaser and payer of record. Any bill, invoice or receipt you provide must show the organization as the pumhaser. Payment must be from the funds of the exempt organization. This form may not oe used to claim exemption for the following: -- the pumh;~se of rector fusi or d~asel motor fuel including Nc:,. 2 heatin,~ 3ii (see Purchaser section) -- ',he ten-cent~-pe~ qbart ~ on ~e ~1 ~ ~ lubfi~i~ oil. ~is ~ is ir:~Fos~ on ~e ~1 ~11~ ~d indud~ in · e pd~e ch~ the pmch~[ -- the ~ial fee 3~ pa0mg a~ic~ ;~nl~. t~ ~mhaser ~ a ~lu~r fire or ~bul~ce ~m~ ~ h~ ~n gmnt~ ~em~ion ~rn ~ios ~d u~ ~ ~m~ ~ ~ion 111~a~4) ~ the ~ I~. ~ ~m ~ ~n, ~e ~m~ ~lu~ tim or ~bu~ ~ ~ ~pp~ the ~ging sewica ~h th~ ~ ~d a I~ ~ ~e~fi~ the ~em~ o~i~ion and ~ ~ E is ~m~ ~m the s~i~ f~ on paging d~ ~ ~ is a ~lu~r tim or ~bulan~ ~m~y (~ N~ice ~-17 ~r ~on~ i~ation.) ~e ~ o~i~tion m~ ~ ~ ~ ~ ~e time ~ ~e o~i~ion's fi~ pumh~. A ~e ~um~ is n~ n~ ~r e~h su~ue~ pu~, p~d~ ~a ~e ~ ~ani~tion's nam~ ~d~, ~d ~ num~ ~ on t~ ~1~ slip or billing in~ic~ ~e ~on is ~ide~ ~ ~ e~h o~er ~d mm~ns in ~me unl~ If a certification with all eotdes completed ia not received within 90 days after the delive~J of the property or service, you will share with the purchaser the bumlen of proving the · ato wa~ axempt. You must keep this Exempt Organization Certification for at least throe yearn after the date of the last exempt sale substantiated by the certification. Purchaser Complete this certification and give it to the seller. You may get additional copies of Form ST-119.1 at any district tax office or by writing to the NYS Tax Department, Taxpayer Assistance Buroau, W A Harriman Campus, Albany NY 122:-.?/. This form may be roproduced without prior permission from the Tax Department. Your exemption from New York State and local .eale~ and use tax does not extend to office.es, membem or empioyee.e of the exempt organization. Personal purchases made by these individuals aro subject to sales and use tax. An organization's exemption does not extend to its subordinate or ~liatod units,, When making purchases, subordinate units may not ~se ~ha exemption number assigned to the parent organization. Such misuse may result in the revocation of the parent organization's exemp~on. You may net use this form to make tax ax, empt purchases of motor fuel, diesel motor fuel, lubricating oil and, if you aro not a voluntary tiro or ambulance company, to avoid the special fee on paging devioes. Since No. 2 heating oil falls within the definition of diesel motor fuel; you may nnt use this form to purchase it tax exempt. You must use Form. FT-1020, Exemp~on Certificate for Certain Taxes Imposed on Diesel MoOr Fuel and PYopane or Form FT-1025, Certificate for Exemption from Certain Taxes Imposed on Diesel Motor Fuel, to claim exemption on heating oil. Hospitals that have been granted an exemption from sales~and use tax pursuant to section 1116(a)(4) of the Tax La~ may claim exemption on the purchase of motor fuel by using Form FT-937, Certificate of Sales Tax and Motor Fuel Tax Exemption for Qualified Hospitals. Subotantlal olvll and/or criminal penalties will result from the miause of this form.