Kentucky Free Printable Multijurisdiction Uniform Sales & Use Tax Certificate for 2021 Kentucky Multijurisdiction Uniform Sales & Use Tax Certificate

A sales tax exemption certificate can be used by businesses (or in some cases, individuals) who are making purchases that are exempt from the Kentucky sales tax. You can download a PDF of the Kentucky Multijurisdiction Uniform Sales & Use Tax Certificate on this page. For other Kentucky sales tax exemption certificates, go here.

If you are exempt from sales tax, this multistate form can be used when you are purchasing tangible goods for your business. The seller is advised to keep this form for record keeping purposes.

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Multijurisdiction Uniform Sales & Use Tax Certificate

UNIFORM SALES & USE TAX CERTIFICATEMULTIJURISDICTION The below-listed states have indicated that this form of certificate is acceptable, subject to the notes on pages 2-4. The issuer and the recipient have the responsibility of determining the proper use of this certificate under applicable laws in each state, as these may change from time to time. Issued to Seller:________________________________________________________________________________________ Address: _____________________________________________________________________________________________ is engaged as a registered Wholesaler Retailer Manufacturer Seller (California) Lessor (see notes on pages 2-4) I certify that: Name of Firm (Buyer): ________________________________ Address: ___________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Other (Specify)_____________ __________________________________________________________ and is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale, ingredients or components of a new product or service1 to be resold, leased, or rented in the normal course of business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) the following: Description of Business: ______________________________________________________________________________________________ General description of tangible property or taxable services to be purchased from the seller: ________________________________________ __________________________________________________________________________________________________________________ State AL1 AR AZ2 CA3 CO4 CT5 DC6 FL7 GA8 HI4,9 ID IL4,10 IA KS KY11 ME12 MD13 MI14 MN15 State Registration, Sellers Permit, or ID Number of Purchaser ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ State MO16 NE17 NV NJ NM4,18 NC19 ND OH20 OK21 PA22 RI23 SC SD24 TN TX25 UT VT WA26 WI27 State Registration, Sellers Permit, or ID Number of Purchaser _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ I further certify that if any property or service so purchased tax free is used or consumed by the firm as to make it subject to a Sales or use Tax we will pay the tax due directly to the proper taxing authority when state law so provides or inform the seller for added tax billing. This certificate shall be a part of each order which we may hereafter give to you, unless otherwise specified, and shall be valid until canceled by us in writing or revoked by the city or state. Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter. Authorized Signature: ________________________________________________________________ (Owner, Partner or Corporate Officer) Title: _____________________________________________________________________________ Date: _____________________________________________________________________________ Revised 1/2009 Page 1 of 4

Extracted from PDF file ky-withmtc.pdf, last modified March 2012

More about the Kentucky Multijurisdiction Uniform Sales & Use Tax Certificate

Other Kentucky Sales Tax Certificates:

SalesTaxHandbook has an additional four Kentucky sales tax certificates that you may need.

Certificate Code Certificate Name
51A158 Farm Certificate of Exemption
51A159 Farm Facilities Materials, Machinery and Equipment Exemption Certificate
SST Streamlined Sales Tax Certificate of Exemption
SST-MULTI Streamlined Sales Tax Certificate of Exemption (Multistate)

Download all KY sales tax exemption forms View all 4 Kentucky Exemption Certificates

SalesTaxHandbook Disclaimer:

While we do our best to keep our list of Kentucky Sales Tax Exemption Certificates up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

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