Exemption Certificate Certain Power Farm Equipment Form printable pdf download

Exemption Certificate Certain Power Farm Equipment Form

EXEMPTION CERTIFICATE

CERTAIN POWER FARM EQUIPMENT

This is to certify that the power farm equipment identified below, purchased on or after

___________ (date) from _____________________________(Selling Dealer's Business Name)

is purchased, leased, licensed, or rented for the following purpose:

( ) Power farm equipment for exclusive use in the agricultural production of crops or products,

as produced by those agricultural industries included in s. 570.02(1), F.S., or

( ) Power farm equipment for exclusive use in fire prevention and suppression work for such

crops or products, as produced by those agricultural industries included in s. 570.02(1), F.S.

POWER FARM EQUIPMENT:

______________________________________________________________________________

I understand that if I use the equipment for any purpose other than the one stated, then I must pay

tax on the purchase or lease price of the taxable item directly to the Department of Revenue. I

understand that if I fraudulently issue this certificate to evade the payment of sales tax I will be

liable for payment of the sales tax plus a penalty of 200% of the tax and may be subject to

conviction of a third degree felony.

The exemption specified by the purchaser may be verified by calling 1-800-352-3671.

Purchaser's Name: ______________________________________________________________

Purchaser's Address: ____________________________________________________________

Name and Title of Purchaser's Authorized Representative: ______________________________

_____________________________________________________________________________

By: ____________________________________________

____________________________

(Signature of Purchaser or Authorized Representative)

Title:_________________________________________________________________________

(Title - only if purchased by an authorized representative of a business entity)

Date _______________________

Exemption Certificate Certain Power Farm Equipment Form