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Form Rv-F1303901 - Certificate Of Exemption For Electric Cooperatives And Membership Corporations And Utility Districts - Tennessee Department Of Revenue

TENNESSEE DEPARTMENT OF REVENUE

CERTIFICATE OF EXEMPTION

For

Electric Cooperatives and Membership Corporations and Utility Districts

TO:

Vendor’s Name and Address

as authorized representative of

(NAME)

(ADDRESS)

do hereby certify the tangible personal property or taxable services provided by the vendor named above are being purchased for use and

consumption by the named Electric Cooperative, Electric Membership Corporation or Governmental Utility District organized and created

under the applicable laws of the State of Tennessee.

I understand that falsification of this document for the purpose of evading the lawful tax may be punishable as provided by the

Tennessee Code Annotated.

NAME

TITLE

Please print

DATE

SIGNATURE

This certificate of exemption may be used by Electric Membership Corporations organized under the provisions of Sections 65-2401, et seq.,

of the Tennessee Code Annotated, Electric Cooperatives organized under the provisions of Sections 62-2501, et seq., of the Tennessee

Code Annotated, and Utility Districts organized under the provisions of Sections 6-2601, et seq., of the Tennessee Code Annotated, or

Private Acts of the Tennessee General Assembly.

CAUTION: This is intended for use only for direct purchases by the named organizations. Direct billings for goods and services made to

contractors and other representatives of the Electric Cooperatives, Electric Membership Corporations and Governmental Utility Districts are

not covered by this exemption certificate.

RV-F1303901 (Rev. 5-00)

Form Rv-F1303901 - Certificate Of Exemption For Electric Cooperatives And Membership Corporations And Utility Districts - Tennessee Department Of Revenue

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