Form St-E1 Application For Certificate Of Exemption Electricity For Manufacturers

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ST-E1 (Rev. 12/01)
Department of Revenue
Sales and Use Tax Division
1800 Century Center Boulevard, NE, Ste. 15311
Atlanta, Georgia 30345-3205
Clear Form
Telephone: (404) 417-6649
APPLICATION FOR CERTIFICATE OF EXEMPTION
ELECTRICITY FOR MANUFACTURERS
The application must be accompanied by a certified utility study conducted for the preceding calendar year. For those
businesses, which have not been in business a calendar year, the study shall be established on the certified projected figures for a
period of 12 consecutive months. The study must be certified by a registered engineer or a person with an engineering degree
from an accredited engineering college. The study is required to establish the average cost of electricity used directly in the
product for sale.
1. Business trade name___________________________________________________________________________________________
2. Mailing address_______________________________________________________________Telephone ______________________
3. Location of manufacturing facility______________________________________________________, Georgia________________
(zip code)
4. Date manufacturing facility entered business in this State______________________________________________________________
MM/DD/YY
5. Total cost of all materials, including electricity, used directly in the product $______________________________________________
6. Total cost of electricity used directly in the product $_________________________________________________________________
7. Total cost of all electricity used in the manufacturing facility $__________________________________________________________
%
8. Electricity cost percentage (line 6 divided by line 5):__________________________________________________________________
NOTE: PERCENTAGE MUST EXCEED 50% TO QUALIFY
The undersigned hereby certifies that the information contained on this application and in the accompanying study is true and correct. The
undersigned further acknowledges the granting of the exemption certificate will allow all purchases of electricity to be made exempt and the
manufacturing facility will be responsible for the accrual and remittance of the tax directly to the Commissioner on those purchases which do
not qualify as exempt under O.C.G.A. § 48-8-2(6)(B)(ii).
GEORGIA SALES AND USE CERTIFICATE NO._________________________________DATE_________
MM/DD/YY
SIGNATURE___________________________________________________TITLE______________________

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