California Code of Regulations › Title 18 - Public Revenues › Division 2 - California Department of Tax and Fee Administration- Business Taxes (State Board of Equalization- Business Taxes, See Ch. 6 and 9.9) › Chapter 4 - Sales and Use Tax › Article 3 - Manufacturers, Producers, Processors › Appendix A

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
EXEMPTION CERTIFICATE
STATE BOARD OF
							 EQUALIZATION
Qualified Sales and Purchases of Liquefied Petroleum
					 Gas (LPG)
SELLER'S NAME
SELLER'S ADDRESS (Street, City, State, Zip Code)
The undersigned purchaser hereby certifies that the LPG
					 will be used by a qualified person, as applicable, and in the manner as
					 specified below
(check
applicable box and complete as
					 necessary)
:
[]LPG used in a Household
					 Activity* -- In accordance with Revenue &
					 Taxation Code Section
					 6353(b),
					 __________ % of the LPG purchased will be delivered by the seller into a tank
					 with a storage capacity equal to or greater than 30 gallons for use in a
					 household activity at the primary residence, which is not serviced by gas mains
					 and pipes, of: 1) the purchaser; 2) a person described in Codes 0711 to 0783 of
					 the Standard Industrial Classification (SIC) Manual, that assists a person
					 engaged in an agricultural business described in Codes 0111 to 0291 of the SIC
					 Manual ("qualified person"), or an employee of a qualified person where the LPG
					 is purchased by such qualified person on behalf of the person that assists a
					 qualified person in producing and harvesting agricultural products, or on
					 behalf of the employee of that qualified person in producing and harvesting
					 agricultural products; or 3) a renter or tenant where the LPG is purchased by a
					 landlord or management company on behalf of the renter or tenant.
[]LPG used in an Agricultural
					 Activity* -- In accordance with Revenue &
					 Taxation Code Section
					 6353(b),
					 __________ % of LPG purchased will be delivered into a tank with a storage
					 capacity equal to or greater than 30 gallons and used in producing and
					 harvesting agricultural products, and will be purchased by: 1) a person engaged
					 in an agricultural business described in Codes 0111 to 0291 of the Standard
					 Industrial Classification (SIC) Manual ("qualified person"); or 2) a person
					 described in Codes 0711 to 0783 of the SIC Manual, that assists a qualified
					 person; or 3) an employee of the qualified person.
* This certificate will be
					 considered a blanket certificate for future purchases, unless otherwise
					 specified. If this is a specific partial exemption certificate, provide the
					 purchase order or sales invoice number in the following space:
__________
I understand that if the LPG is not used in the manner
					 qualifying for the partial exemption, or if I am not a qualified person, as
					 applicable, that I am required by the Sales and Use Tax Law to report and pay
					 the state tax measured by the sales price of the LPG to me. I also understand
					 that this exemption certificate is in effect as of the date shown below and
					 will remain in effect until revoked in writing.
PURCHASER'S NAME OR COMPANY NAME (If
							 applicable)
DATE
SIGNATURE (signature of the purchaser,
							 purchaser's employee, or authorized representative of the
							 purchaser)
PERMIT NUMBER (If
							 applicable)1
TITLE
TELEPHONE NUMBER
ADDRESS
CITY
STATE, ZIP
1. If you are not required to hold a seller's permit,
					 please enter "Not Applicable."