Sales Tax Exemption Form

SALES TAX EXEMPTION FORM

SALES TAX EXEMPTION FORM

LPG Sales Tax Exemption Certificate

customers only qualify for tax exempt if the residence is their primary residence. (This means they live there more than 6 months out of the year)*

I certify that I am purchasing Liquefied Petroleum Gas/LPG (Propane) from Kemgas, 1300 N. Main St, Fort Bragg, CA (Kemgas) without sales or use tax (effective September 1, 2001) under section 6353(b) of the California Revenue and Taxation Code, and which qualifies for the tax exemption indicated below:

Propane for Household Use

I further certify that the Propane purchased and delivered by Kemgas is being delivered to my primary residence not serviced by gas mains and pipes, for use therein, in accordance with Revenue & Taxation Code Section 6353(b). I further certify that the Propane is being delivered into a tank with a storage capacity that is equal or greater than 30 gallons.

I understand that if the Propane purchased and delivered by Kemgas is not used in a qualified manner, or if I am not a qualified person, that I am required by the Sales and Use Tax Law to report and pay the sales tax measured by the sales price of the property to me. I also understand that this exemption certificate is in effect of the date shown below and will remain in effect until revoked in writing.

Propane Reseller

I certify that I am engaged the business of selling tangible personal property that is subject to tax when sold at retail and hold a California State sellers permit.

I understand that if the Propane purchased and delivered by Kemgas is not used in a qualified manner, or if I am not a qualified person, that I am required by the Sales and Use Tax Law to report and pay the sales tax measured by the sales price of the property to me. I also understand that this exemption certificate is in effect of the date shown below and will remain in effect until revoked in writing.

Propane is used in Producing and Harvesting Agricultural Products

I further certify that I am engaged in business in an industry described in Codes 0111 to 0291 of the Standard Industrial Classification Manual or that I assist such classified persons. I further certify that the LPG purchased will be used in producing and harvesting agricultural products in accordance with Revenue & Taxation Code Section 6353(b). I further certify that the Propane is being delivered into a tank with a storage capacity that is equal or greater than 30 gallons.

I understand that if the Propane purchased and delivered by Kemgas is not used in a qualified manner, or if I am not a qualified person, that I am required by the Sales and Use Tax Law to report and pay the sales tax measured by the sales price of the property to me. I also understand that this exemption certificate is in effect of the date shown below and will remain in effect until revoked in writing.


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