Wyoming Sales and Use Tax
Tax must be collected on all
Exemption Certificate
sales
of
tangible
personal
property or taxable services
Cannot be used to purchase Gasoline or Special Fuel
unless
an
Exemption
(see back of this form for instructions)
Certificate is furnished. Read
State of Wyoming
instructions on back of form
Revenue ID#______________
Issued To:
Vendor
Date
Street Address
City
State
Zip Code
To Be Completed By Purchaser: I, the undersigned, hereby certify that I am making an exempt purchase as follows:
If a vendor, my active Wyoming sales/use tax license number is:
My principal business or activity is:
I claim an exemption for the following reason (place an X in applicable box or boxes):
Purchase For Resale: (See instructions on back)
1. Purchases made for resale or taxable services for resale.
Purchase By Commercial Agricultural Producer: (See instructions on back)
2. Purchase of livestock kept for agricultural use or for resale or for profit, which includes, but is not limited to: horses, cattle, mules, asses,
sheep, swine, llamas, bison, ostrich, emu, poultry, fish, and honey bees.
3. Purchase of power or fuel used directly in agriculture. Must be metered, stored, or separately accounted for to distinguish it from
non-exempt power or fuel.
4. Purchase of feeds used in commercial feeding of livestock for marketing purposes. Also includes seeds, roots, bulbs, small plants, and
fertilizer planted or applied to land, the products of which are to be sold or applied to land in a state or federal crop set aside program.
Purchase Of Rolling Stock: (See instructions on back)
5. Purchase of rolling stock including locomotives purchased by interstate railroads, aircraft purchased by interstate air carriers and trucks,
truck tractors, trailers, semitrailers and passenger buses purchased by interstate carriers which are holders of valid Federal Highway
Administration or Civil Aeronautics Board permits or authorities if they are to be substantially used in interstate commerce.
Purchase Made By Persons Engaged In Manufacturing, Processing Or Compounding: (See instructions on back)
6. Purchases of tangible personal property for manufacturing, processing or compounding if that property becomes an ingredient or
component of the final manufactured product.
7. Purchase of containers, labels or shipping cases used for the tangible personal property so manufactured, processed or compounded.
8. Purchase of power or fuel by a person engaged in the business of manufacturing or processing when the same is consumed directly in
manufacturing or processing. Must be metered, stored, or separately accounted for to distinguish it from non-exempt power or fuel.
9. Purchase of power or fuel by a person engaged in the transportation business when the power or fuel is used in generating motive power
for actual transportation purposes.
10. Purchases of fuel for use as boiler fuel in the production of electricity.
Purchase Made By Exempt Organizations: (See Instructions on back)
11.* Purchase made by religious or charitable organizations.
12. Purchase made by the United States Government.
13. Purchase made by the State of Wyoming or its political subdivisions.
14. Purchase made by Wyoming Joint Apprenticeship Training Programs.
15. Purchase made by Wyoming Joint Powers Boards.
16.* Purchase made by non-profit organizations providing meals or services to senior citizens.
17. Purchase made by an Irrigation District created under W.S. 41-7-201 through W.S. 41-7-210.
18. Purchase made by a Weed and Pest District.
Purchase Made By Native Americans: (See instructions on back)
19. Purchase made on the reservation by enrolled tribal members residing on the Wind River Indian Reservation.
Note: * You must have prior approval from the Department of Revenue before taking this exemption.
I understand that by signing this certificate I may make "tax free" purchases of tangible personal property or purchase taxable services which are for
exempt purposes.
I will pay sales or use tax on all tangible personal property used or consumed in a taxable manner. In addition, I understand that I
will be liable for the tax due, plus substantial penalties and interest, for any erroneous or false use of this certificate.
Name Of Purchaser
Street Address
Signature Of Owner, Partner, Officer Of Corporation, etc.
City
Title
State
Zip Code
Over for Instructions:
ETS Form 101(4/3/98)