CERT-119
General Purpose: A qualifying exempt organization must issue
this certificate to retailers when purchasing items to be used by the
organization exclusively for the purposes for which it was established.
Under Conn. Gen. Stat. §12-412(8), a qualifying exempt organization
is either:
an organization that was issued an exemption permit before
July 1, 1995, by the Department of Revenue Services (DRS) under
Conn. Agencies Regs. §12-426-15, if the permit has not been
canceled or revoked by DRS; or
an organization that is exempt from federal income tax under
I.R.C. §501(a) and has been issued a determination letter by the
U.S. Treasury Department as an organization described in
I.R.C. §501(c)(3) or (13), if the determination letter has not been
revoked by the Internal Revenue Service.
A qualifying exempt organization may use this certificate to purchase
any tangible personal property for resale at one of five fund-raising or
social events of a days duration during any calendar year. The event
must be exempt from tax under Conn. Gen. Stat. §12-412(94). Otherwise,
exempt organizations are not allowed to purchase tangible personal
property for resale with this certificate.
This certificate may not be used for the purchase of meals or lodging,
unless a qualifying exempt organization is purchasing meals for resale
at one of five fund-raising or social events per year that is exempt from
tax under Conn. Gen. Stat. §12-412(94). (See Special Notice 98(11),
Exemption From Sales and Use Taxes of Sales by Nonprofit
Organizations at Fundraising or Social Events.)
If the purchaser is not a qualifying exempt organization or does not
use the property or services purchased exclusively for the purposes
for which the organization was established, the purchaser owes use
tax on the total purchase price of the property or services.
Statutory Authority: Conn. Gen. Stat. §12-412(8) and (94).
Instructions for the Purchaser: An officer of a qualifying exempt
organization must issue and sign this certificate to advise the seller of
tangible personal property or taxable services that sales and use taxes
do not apply to the purchase. Keep a copy of this certificate, the
documents attached, and records that substantiate the information
entered on this certificate for at least six years from the date this
certificate is issued.
The purchaser must attach to this certificate a copy of the:
exemption permit issued to the organization by DRS under Conn.
Agencies Regs. §12-426-15; or
determination letter or group exemption letter issued by the
Internal Revenue Service which establishes that the organization
has been determined to be an exempt organization described in
I.R.C. §501(c)(3) or (13).
(Revised 06/00)
Certificate for Purchases of Tangible Personal Property
and Services by Qualifying Exempt Organizations
Note: For purchases made on or after January 1, 1996, a qualifying
exempt organization that is covered by a group exemption letter, and
that was not issued an exemption permit by DRS under Conn. Agencies
Regs. §12-426-15, must attach to this certificate a copy of:
the group exemption letter issued by the Internal Revenue Service
to subordinate organizations (including the qualifying exempt
organization) on whose behalf a central organization applied for
recognition of exemption;
the organizations written consent to the central organization to
be covered by the group exemption letter; and
the central organizations written notification to the Internal
Revenue Service that the organization consents to be covered
by the group exemption letter.
Instructions for the Seller: Acceptance of this certificate, when
properly completed, relieves the seller from the burden of proving
that the sale and the storage, use or consumption of the tangible
personal property or taxable services are not subject to sales and use
taxes. This certificate is valid only if taken in good faith from a qualifying
exempt organization. The good faith of the seller will be questioned if
the seller knows of facts that suggest the purchaser is not a qualifying
exempt organization.
Keep this certificate, the documents attached, and bills or invoices to
the purchaser for at least six years from the date that the items or
services were purchased. The bills, invoices or records covering the
purchase made under this certificate must be marked Exempt Under
CERT-119 to indicate that the purchase was exempt.
This certificate may be used for a single exempt purchase, in which
case the box marked Certificate for One Purchase Only must be
checked. This certificate may also be used for a continuing line of
exempt purchases, in which case the box marked Blanket Certificate
must be checked. A Blanket Certificate remains in effect for one year,
unless the purchaser revokes it in writing before the expiration of the
one year period.
An exempt organization must pay for its exempt purchases by a check
drawn on its checking account or by a credit card issued in its name
(and not in the name of any of its members or officers). An exempt
organization may make a purchase of $10 or less using cash from the
organizations own funds. However, a blanket CERT-119 may not be
used for a cash purchase, and a properly completed CERT-119, with
the appropriate documents attached, must be issued to the retailer at
the time of each cash purchase.
For Further Information: Call Taxpayer Services at
1-800-382-9463 (toll-free within Connecticut) or 860-297-5962 (from
anywhere).
TTY, TDD, and Text Telephone users only may transmit
inquiries 24 hours a day by calling 860-297-4911. Preview and
download forms and publications from the DRS Web site:
www.drs.state.ct
State of Connecticut
Department of Revenue Services
Taxpayer Services Division
25 Sigourney Street
Hartford CT 06106-5032
Name of Purchaser Address CT Tax Registration Number (If any) Exemption Permit # (If any)
Federal Employer ID #
Name of Seller Address CT Tax Registration Number (If any) Federal Employer ID #
Check One Box:
o
Blanket Certificate
o
Certificate for One Purchase Only
Check the Appropriate Box and Provide a Written Description of Each Item Purchased:
o
Tangible Personal Property
o
Taxable Services
Description:
DECLARATION BY PURCHASER
The qualifying exempt organization declares that the tangible personal property or taxable services described above will be used exclusively for the purposes
for which the organization was established, including the purchase of tangible personal property or meals for resale at one of five fundraising or social events
per year that are exempt from tax. The organization further declares that the exemption permit, determination letter or group exemption letter (as the case may
be) attached to this certificate has not been canceled or revoked.
According to Conn. Gen. Stat. §12-412(8) or Conn. Gen. Stat. §12-412(94), the purchase of the item(s) is exempt from sales and use taxes.
I declare under the penalty of false statement that I have examined the information in this certificate and to the best of my knowledge and belief it is true,
complete, and correct. (The penalty for false statement is imprisonment not to exceed one year or a fine not to exceed two thousand dollars, or both.)
Name of Purchaser
By:
Signature of Authorized Person Title Date
CERT-119 (Rev. 06/00)
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