Form Tc-721g - Exemption Certificate Form For Government And Schools
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1Utah State Tax Commission
TC-721G
Exemption Certificate for Governments & Schools
Rev. 3/16
(Sales, Use, Tourism and Motor Vehicle Rental Tax)
Name of institution claiming exemption (purchaser)
Telephone Number
Street Address
City
State
ZIP Code
Authorized Signature
Name (please print)
Title
Date
Name of Seller or Supplier:
The person signing this certificate MUST check the applicable box showing the basis for which the exemption is being claimed.
Email questions to taxmaster@utah.gov. You may also write or visit the Tax Commission at 210 N 1950 W, Salt Lake City, UT 84134, or call
801-297-2200 or toll free 1-800-662-4335.
DO NOT SEND THIS CERTIFICATE TO THE TAX COMMISSION
Keep it with your records in case of an audit.
Print Form
Clear form
❑
❑
UNITED STATES GOVERNMENT OR NATIVE AMERICAN TRIBE
UTAH LOCAL GOVERNMENTS AND PUBLIC ELEMENTARY
I certify the tangible personal property or services purchased are to
AND SECONDARY SCHOOLS
be paid directly with funds from the entity noted on this form and will
Sales Tax License No. _ __ ___ __ __ __ _ _ _ _
be used in the exercise of essential governmental or tribal functions.
I certify the tangible personal property or services purchased are to
NOTE: Includes sales of tangible personal property to federally
be paid directly with funds from the entity noted on this form and will
chartered credit unions. “Directly” does not include per diem, entity
be used in the exercise of that entity’s essential functions. For
advances, or government reimbursements for employee credit card
construction materials, if the purchaser is a Utah local government,
purchases.
these construction materials will be installed or converted into real
❑
property by employees of this government entity.
CONSTRUCTION MATERIALS PURCHASED FOR SCHOOLS
CAUTION: This exemption does not apply to government or educa-
OR PUBLIC TRANSIT DISTRICTS
tional entities of other states and is not valid for lodging-related
I certify the construction materials purchased are on behalf of a
purchases.
public elementary or secondary school, or public transit district. I
❑
further certify the purchased construction materials will be installed
UTAH STATE GOVERNMENT
or converted into real property owned by the school or public transit
Sales Tax License No. _ __ ___ __ __ __ _ _ _ _
district.
I certify the tangible personal property or services purchased are to
Name of school or public transit district:
be paid directly with funds from the entity noted on this form and will
___ _ _ __ __ __ _____ _ _________ _ _ __ _ _
be used in the exercise of its essential functions. For construction
materials, they will be installed or converted into real property by
Name of project: __ ____ _ _ __ _ _ _ _ __ _ _ _ _ __ _
employees of this government entity.
❑
FOREIGN DIPLOMAT
CAUTION: This exemption does not apply to other states and is not
valid for lodging-related purchases.
I certify the purchases are authorized by a diplomatic tax exemption
❑
card issued by the United States.
HEBER VALLEY HISTORIC RAILROAD
Foreign diplomat number: __ __ _ _ _ _ __ _ _ _ _ _ __ _ _
I certify these purchases and sales are by the Heber Valley Historic
Railroad Authority or its operators and are related to the operation
and maintenance of the Heber Valley Historic Railroad.
IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.
Clear form
To be valid this certificate must be filled in completely, including a check mark in the proper box.
A sales tax license number is required only where indicated.
Please sign, date and, if applicable, include your license or exemption number.
NOTE TO SELLER: Keep this certificate on file since it must be available for audit review.
NOTE TO PURCHASER: Keep a copy of this certificate for your records. You must notify the seller of cancellation, modification, or limitation of the
exemption you have claimed.
If you need an accommodation under the Americans with Disabilities Act, email taxada@utah.gov, or call 801-297-3811 or TDD 801-297-2020.
Please allow three working days for a response.
DO NOT SEND THIS CERTIFICATE TO THE TAX COMMISSION
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