EXEMPTION CERTIFICATE FOR PURCHASES OF
COMMUNICATIONS SERVICES BY
HOMES FOR THE AGED
DATE:____________________________
TO:_______________________________ (Selling Dealer's Business Name)
_________________________________ (Selling Dealer's Address)
I, the undersigned, am a representative of the exempt home for the aged identified below. The purchases of communications services made on or after ________________ from the business identified above are for use by the home for the aged identified below.
The charges for the purchases of communications services from the dealer identified above will be billed to and paid directly by the exempt home for the aged identified below. These purchases are exempt from the Florida communications services tax and the local communications services tax because the entity is exempt from federal income tax under s. 501(c)(3) of the Internal Revenue Code, holds a valid Florida Consumer's Certificate of Exemption, and is a "home for the aged, " as defined by Section 202.125(4), F.S.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true.
_____________________________________________________________________________
AUTHORIZED SIGNATURE ON BEHALF OF THE EXEMPT HOME FOR THE AGED
_____________________________________________________________________________
PRINTED NAME OF AUTHORIZED SIGNATORY AND TITLE
_____________________________________________________________________________
NAME OF THE EXEMPT HOME FOR THE AGED
_____________________________________________________________________________
ADDRESS OF EXEMPT HOME FOR THE AGED
EXEMPTION CERTIFICATE FOR PURCHASES OF
COMMUNICATIONS SERVICES BY
RELIGIOUS INSTITUTION
DATE: _____________________________
TO: ________________________________ (Selling Dealer's Business Name)
________________________________ (Selling Dealer's Address)
I, the undersigned, am a representative of the exempt religious institution identified below. The purchases of communications services made on or after _________________________ from the business identified above are for use by the exempt religious institution identified below.
The charges for the purchases of communications services from the dealer identified above will be billed to and paid directly by the exempt religious institution identified below. These purchases are exempt from the Florida communications services tax and the local communications services tax because the entity is exempt from federal income tax under s. 501(c)(3) of the Internal Revenue Code and is a "religious institution" as that term is defined by Section 202.125(4), F.S.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true.
________________________________________________________________________
AUTHORIZED SIGNATURE ON BEHALF OF THE EXEMPT INSTITUTION
________________________________________________________________________
PRINTED NAME OF AUTHORIZED SIGNATORY AND TITLE
________________________________________________________________________
NAME OF THE EXEMPT INSTITUTION
________________________________________________________________________
ADDRESS OF EXEMPT INSTITUTION
EXEMPTION CERTIFICATE FOR PURCHASES OF
COMMUNICATIONS SERVICES BY
EDUCATIONAL INSTITUTIONS
DATE: ____________________________
TO: ______________________________ (Selling Dealer's Business Name)
_________________________________ (Selling Dealer's Address)
I, the undersigned, am a representative of the exempt educational institution identified below. The purchases of communications services made on or after _________________________ from the business identified above are for use by the exempt educational institution identified below.
The charges for the purchases of communications services from the dealer identified above will be billed to and paid directly by the exempt educational institution identified below. These purchases are exempt from the Florida communications services tax and the local communications services tax because the entity is exempt from federal income tax under s. 501(c)(3) of the Internal Revenue Code and is an "educational institution, " as defined by Section 202.125(4), F.S.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true.
________________________________________________________________________
AUTHORIZED SIGNATURE ON BEHALF OF THE EXEMPT INSTITUTION
________________________________________________________________________
PRINTED NAME OF AUTHORIZED SIGNATORY AND TITLE
________________________________________________________________________
NAME OF THE EXEMPT INSTITUTION
________________________________________________________________________
ADDRESS OF EXEMPT INSTITUTION
Fla. Admin. Code Ann. R. 12A-19.043
Rulemaking Authority 202.26(3)(c) FS. Law Implemented 92.525(2), 202.125(4), 202.13(2), 202.16(4), 202.26(2), 202.34(3), 213.37 FS.
New 1-31-02, Amended 4-17-03, 1-1-04.