Form St-587 - Equipment Exemption Certificate - 2003
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1Illinois Department of Revenue
ST-587
Equipment Exemption Certificate
Step 1: Identify the seller
The seller must keep this certificate.
Name
Phone
(_____ ) ________________________________________
_______________________________________________
Address
IBT no.
_____________________________________________
____ ____ ____ ____ - ____ ____ ____ ____
Number and street
Illinois business tax number
___________________________________________________
__
City
State
ZIP
Step 2: Identify the purchaser (lessor)
( _______ ) ______________________________________
Name
Phone
_______________________________________________
Address
Date of purchase
_____________________________________________
___ ___/___ ___/___ ___ ___ ___
Number and street
Month
Day
Year
___________________________________________________
__
City
State
ZIP
Step 3: Identify the lessee
Name
Phone
( _______ ) ______________________________________
_______________________________________________
Address
_____________________________________________
Number and street
___________________________________________________
__
City
State
ZIP
Step 4: Identify the equipment* you are purchasing (or leasing)
* Equipment includes machinery and repair/replacement parts
Type of equipment
___________________________________________________________________________________________
Serial no.
___________________________________________________________________________________________________
Step 5: Identify how you will use this equipment.
Check the appropriate box.
I state that this equipment will be used
primarily in the manufacturing or assembling of tangible personal property for wholesale or retail sale or lease.
primarily in agriculture production.
Step 6: Sign below
Under penalties of perjury, I state that I have examined this certificate and, to the best of my knowledge, it is true, correct, and
complete.
_______________________________________________________________________________________
__ __/__ __/__ __ __ __
Purchaser’s signature
Date
You may photocopy this form or you may request additional forms by visiting our web site at or by writing us or
calling our Springfield office weekdays between 8 a.m. and 5 p.m. Our address and telephone number are below.
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19010
SPRINGFIELD IL 62794-9010
217 785-3707
SOY-BASE INK
This form is authorized as outlined by the Registration and Licensing Division and has been approved by the Forms Management Center.
IL-492-3002
RECYCLED PAPER
ST-587 (R-8/03)
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