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Utah State Tax Commission

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Sales Tax Exemption Certificate For Non-Utah Retailers Accepting Delivery of Merchandise in Utah

TC-721 NR Rev. 4/95

To (Name of Vendor):

This is to certify that

is a dealer in tangible personal

property or services and that the tangible personal property or services purchased from the above-named vendor and shown on invoice number(s) are for resale as tangible personal property or

services. The property will NOT be used in real property contract work or for any other personal or business use. My retail sales license number in the state of is .

This certificate shall be valid only for the specific purchases referenced by the invoice number(s) noted above. A new certificate must be completed each time a non-Utah retailer accepts delivery of merchandise in Utah.

To be valid this certificate must be filled in completely including date, signature and license number.
Signature

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Title

Please sign this form by hand after it is printed.
Name of Business (print or type)

Address

City

State

Zip Code

IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.

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DO NOT SEND THIS CERTIFICATE TO THE TAX COMMISSION
NOTE TO VENDOR:------- Keep this certificate on file since it must be available for audit review. NOTE TO PURCHASER:------- Keep a copy of this certificate for your records. You are responsible to notify the vendor of cancellation, modification, or limitation of the exemption you have claimed.

Questions about the propriety of accepting this certificate from an out-of-state customer should be directed to Taxpayer Services Division, Utah State Tax Commission, 210 N 1950 W, Salt Lake City, Utah 84134, Telephone (801) 297-2200, or toll free 1-800-662-4335.

If you need an accommodation under the Americans with Disabilities Act, contact the Tax Commission at (801) 297-3811 or TDD (801) 297-3819. Please allow three working days for a response.

TC-721NR.CDR Rev. 4/95