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Form St-Ce1 - Application For Certificate Of Exemption Computer Equipment For A High Technology Company

ST-CE1 (01/2001)

STATE OF GEORGIA

Department of Revenue

Sales and Use Tax Division

Post Office Box 740390

Atlanta, Georgia, 30374-0390

Telephone: (404) 656-4060

APPLICATION FOR CERTIFICATE OF EXEMPTION

COMPUTER EQUIPMENT

FOR A HIGH TECHNOLOGY COMPANY

CALENDAR YEAR PURCHASES MUST MEET THE $15 MILLION REQUIREMENT

1. Legal Business Name

2. D/B/A Name

3. Mailing Address

Telephone (___)

4. Business location

, Georgia

5. Standard or North American Industrial Classification Code:

IRS Designation of Company

Location Designation (If applicable)

6. Will machinery be:

[ ] Purchased

[ ] Leased

[ ] or Both

7. Anticipate date purchases leases will begin:

, be completed:

List the type of computer equipment for which exemption is claimed, and estimated book value of each.

Equipment

Purchase Price or Book Value

Attach separate equipment list if needed.

The undersigned hereby certifies that purchases or leases of computer equipment for a high technology company comes within the exemption

provisions of O.C.G.C § 48-8-3(68) and that the equipment will solely be used at the above stated business location.

GEORGIA CERTIFICATE OF REGISTRATION NO.

DATE

(IF APPLICABLE)

SIGNATURE

TITLE

Form St-Ce1 - Application For Certificate Of Exemption Computer Equipment For A High Technology Company