SDE
Exemption from Surety Deposits for Non-Minnesota Contractors
Please type or print clearly. This information will be used for returning the form to you.
Contractor
Total contract amount
Minnesota tax ID number
$
Address
Contact person
Daytime phone
City
State
ZIP code
Contract starting date
Projected completion date
Business type (check one):
Corporation
S corporation
Partnership
Sole proprietor
Name of business or government agency
Contact person
Daytime phone
Contract owner’s address
City
State
ZIP Code
Project number
Project location address
City
State
ZIP code
I request exemption from surety deposits under Minnesota law (M.S. 290.9705) for the following reason (check one box
only and complete the information requested):
I have a cash surety or a bond secured by an insurance company licensed in Minnesota. The bond must be 8 percent of the total
contract amount. Attach a copy of Form SDB, Non-Minnesota Contractor’s Bond.
Bonding company
Bonding agent
Address
Daytime phone
City
State
ZIP code
Period of bond (month/day/year)
From
/
/
To
/
/
I have done construction work in Minnesota during the past three calendar years and have fully complied with Minnesota law
regarding Minnesota income, sales and use, corporate franchise and withholding taxes.
I am performing work for a government agency and have a payment and performance bond.
I am performing work for a government agency and have a cash surety issued by a state bank, national bank, or savings and
loan association doing business in Minnesota.
I declare this information is true and complete to the best of my knowledge and belief. I authorize the Department of Revenue to
send a copy of this form to the contract owner and discuss this case and related taxes with the bonding company.
Contractor’s signature
Title
Date
Mail to: Minnesota Revenue, Mail Station 5410, St. Paul, MN 55146-5410
Department of Revenue Approval
The above-named non-Minnesota contractor is exempt from the surety requirements of Minnesota Statute 290.9705 for this project.
Department of Revenue approval
Date
(Rev. 1/14)