Agricultural Sales And Use Tax Certificate Of Exemption Page 2
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1
2Instructions
Application for Registration
Agricultural Sales and Use Tax Certificate of Exemption
Instructions:
Item 1: Indicate whether application is being submitted for a new exemption certificate or to renew an existing certificate.
Item 2: Indicate whether you are a farmer, timber harvester, or nursery operator.
Item 3: Provide the legal name and address of the business for which exemption is requested. If requesting for yourself as an
individual, please enter your name and your location address.
Item 4: Provide the primary mailing address where correspondence regarding this exemption should be mailed.
Item 5: Provide the telephone number, fax number, and e-mail address of the person or business being registered.
Item 6: Enter the social security number of the individual or federal employer identification number (FEIN) of the business.
Item 7: Indicate the legal form of the person or business for whom the exemption is requested.
Item 8: If the business for which exemption is being requested is not a sole proprietor, husband and wife ownership, or general
partnership, enter the name of the business, as registered with the Tennessee Secretary of State (SOS), and the SOS
number.
Item 9: You must meet one or more of the criteria listed on the front of this application to be eligible for an agricultural sales
and use tax exemption as a farmer, timber harvester, or nursery operator. Check the block in Item 9 next to the
qualification under which the individual or business qualifies for exemption. Supporting documentation of exemption
authorization must be submitted with this application as indicated.
Item 10: The individual or the primary member of the business for which exemption is being requested must provide the
person’s printed name, sign the application form, and provide the date on which the application is being submitted.
WARNING: Persons qualifying for this exemption will be liable for tax, penalty, and interest on purchases made without the
payment of tax if such purchases are not used directly and principally in producing agricultural products for sale and consump-
tion off the premises or if they allow other persons to use their exemption certificate or number to make tax-exempt purchases.
For more information concerning the types of purchases that can be made by qualifying farmers, timber harvesters, and nursery
operators, please visit the department’s web site or call the department at the numbers listed below.
Return this application and appropriate documents to the Tennessee Department of Revenue, Taxpayer Services Division,
Andrew Jackson State Office Building, 500 Deaderick Street, Nashville Tennessee 37242. You can fax the application to the
Department at (615) 532-9784. If you have questions or need to assistance, you can call the Department at (615) 253-0600.
Callers within Tennessee but outside the Nashville calling area call 1-800-342-1003. You may also e-mail the department at
Tn.Revenue@tn.gov. Our web site address in
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