Form St-M7 - Application For Certificate Of Exemption Machinery For Reducing Or Eliminating Air Or Water Pollution

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ST-M7 (Rev. 7/06)
Department of Revenue
Sales and Use Tax Division
1800 Century Center Boulevard, NE, Ste. 15311
Atlanta, Georgia 30345-3205
Telephone: (404) 417-6649
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APPLICATION FOR CERTIFICATE OF EXEMPTION
MACHINERY FOR REDUCING OR ELIMINATING AIR OR WATER POLLUTION
[ ] AIR POLLUTION
[ ] WATER POLLUTION
(Separate Applications Must Be Filed For Each Category)
1. Business trade name ____________________________________________________________________________________
2. Mailing address ________________________________________________________________________________________
3. Machinery to be installed at: ____________________________________________________________ , Georgia _________
4. Type of business:
[ ] Textiles
[ ] Food Processing
[ ] Paper
[ ] Chemicals
[ ] Mining
[ ] Other
5. List type of machinery for which exemption is claimed; its function in pollution control; and estimated cost.
TYPE
COST
FUNCTION
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
6. Will machinery and equipment be:
[ ] Purchased
[ ] Leased
[ ] or Both?
(MM/DD/YY)
7. Anticipated date purchases/leases will begin: _________________________ , be completed: ___________________________
(MM/DD/YY)
8. Is the machinery and equipment to be purchased by a contractor as a part of a lump sum contract which also includes real
property construction: [ ] Yes;
[ ] No? If yes, provide, contractor’s name and address.
Name __________________________________________________________________
Address ________________________________________________________________
The undersigned hereby certifies that purchases/leases of machinery and equipment to be installed at the above plant location come within the
exemption provisions of O.C.G.A. § 48-8-3(36) and (37).
SIGNATURE ____________________________________________________ TITLE _________________________________
TELEPHONE ____________________________________________________ DATE __________________________________
(MM/DD/YY)
A CERTIFICATE OF EXEMPTION (ST-M8) WILL BE ISSUED ON ALL QUALIFYING MACHINERY.

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