SUGGESTED PURCHASER'S EXEMPTION CERTIFICATE
BOILER FUELS USED TO PRODUCE TANGIBLE PERSONAL PROPERTY FOR SALE
I, the undersigned individual, hereby certify that I am the purchaser or the purchaser's agent or representative authorized to act for ________________________ (PURCHASER) in the purchase of boiler fuels. The purchases of natural gas, residual oil, recycled oil, waste oil, solid waste as defined in Section 403.703(35), Florida Statutes, coal, sulfur, hydrogen, wood, wood residues, or wood bark from _______________________________ (SELLER) under account number __________ will be exclusively used as a combustible fuel in the manufacturing, processing, compounding, or production of tangible personal property for sale. This industrial process is located at ____________________________ (ADDRESS) in _______________, Florida.
I further certify that_____________________ (PURCHASER) is not subject to regulation by the Division of Hotels and Restaurants, Department of Business and Professional Regulation, and the purchase of combustible fuel as identified in this certificate is exempt from sales and use tax as provided in Section 212.08(7)(b), Florida Statutes.
I understand that if I fraudulently issue this certificate to evade the payment of sales and use tax, I will be liable for payment of the tax plus a penalty of 200% of the tax and may be subject to conviction of a third-degree felony.
Under penalties of perjury, I declare that I have read the foregoing certificate and that the facts stated in it are true.
____________________________________________________________
Signature of Purchaser or Purchaser's Agent or Representative
___________________________________________
Title
_____________________
Date
Cross Reference: Rule 12A-1.022, F.A.C., for guidelines on federal excise taxes, gross receipts tax, and other fees; Rules 12A-1.087 and 12B-5.130, F.A.C.
EXEMPTION CERTIFICATE
NATURAL GAS USED TO GENERATE ELECTRICITY
IN A NON-COMBUSTION FUEL CELL USED IN STATIONARY EQUIPMENT
I certify that natural gas purchased on or after _____________________________________ (Date) from ________________________ (Selling Vendor's Name) will be used to generate electricity in a non-combustion fuel cell used in stationary equipment.
I understand that if I use the purchased natural gas for any nonexempt purpose, I must pay tax on the purchase price of the natural gas directly to the Florida Department of Revenue.
I understand that if I fraudulently issue this Certificate to evade the payment of Florida sales tax, I will be liable for payment of the tax, plus a penalty of 200% of the tax, and may be subject to conviction of a third degree felony.
Under the penalties of perjury, I declare that I have read the foregoing Certificate and the facts stated herein are true.
__________________________________________________
SIGNATURE OF PURCHASER OR AUTHORIZED AGENT
_______________________
TITLE OR DESIGNATION
_________________
DATE
Cross Reference: Rule 12A-1.022, F.A.C., for guidelines on federal excise taxes, gross receipts tax, and other fees; and Rule 12B-5.130, F.A.C.
Fla. Admin. Code Ann. R. 12A-1.059
Rulemaking Authority 212.18(2), 213.06(1) FS. Law Implemented 206.86(4), 212.05, 212.06(3), 212.08(4), (7), (8) FS.
New 10-7-68, Amended 6-16-72, 7-19-72, 12-11-74, 10-18-78, 7-3-79, 6-3-80, 12-23-80, 8-26-81, 12-31-81, 7-20-82, 10-13-83, Formerly 12A-1.59, Amended 12-13-88, 5-19-93, 9-14-93, 3-20-96, 10-2-01, 4-17-03, 6-12-03, 5-9-13, 1-20-14, 10-26-22.