Fillable Form 3372 (Rev. 08-12): Michigan Sales and Use (City of Traverse City)

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Form 3372 (Rev. 08-12): Michigan Sales and Use (City of Traverse City)

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The Form 3372 (Rev. 08-12): Michigan Sales and Use (City of Traverse City) form is 1 page long and contains:

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  • 13 check-boxes
  • 19 other fields

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Michigan Department of Treasury
Form 3372 (Rev. 08-12)
Michigan Sales and Use Tax Certificate of Exemption
DO NOT send to the Department of Treasury. Certificate must be retained in the seller’s records. This certificate is invalid unless all four sections
are completed by the purchaser.
SECTION 1: TYPE OF PURCHASE
A. One-Time Purchase C. Blanket Certificate
Order or Invoice Number:
Expiration Date (maximum of four years):
B. Blanket Certificate. Recurring Business Relationship
The purchaser hereby claims exemption on the purchase of tangible personal property and selected services made from the vendor listed below. This
certifies that this claim is based upon the purchaser’s proposed use of the items or services, OR the status of the purchaser.
Vendor’s Name and Address
SECTION 2: ITEMS COVERED BY THIS CERTIFICATE
Check one of the following:
1. All items purchased.
2. Limited to the following items:
SECTION 3: BASIS FOR EXEMPTION CLAIM
Check one of the following:
1. For Resale at Retail. Enter Sales Tax License Number:
2. For Lease. Enter Use Tax Registration Number:
The following exemptions DO NOT require the purchaser to provide a number:
3. For Resale at Wholesale.
4. Agricultural Production. Enter percentage: %
5. Industrial Processing. Enter percentage: %
6. Church, Government Entity, Nonprofit School, or Nonprofit Hospital (Circle type of organization).
7. Nonprofit Internal Revenue Code Section 501(c)(3) or 501(c)(4) Exempt Organization (must provide IRS authorized letter with this form).
8.
Nonprofit Organization with an authorized letter issued by the Michigan Department of Treasury prior to June 1994 (must provide copy of
letter with this form).
9. Rolling Stock purchased by an Interstate Motor Carrier.
10. Other (explain):
SECTION 4: CERTIFICATION
I declare, under penalty of perjury, that the information on this certificate is true, that I have consulted the statutes, administrative rules and other
sources of law applicable to my exemption, and that I have exercised reasonable care in assuring that my claim of exemption is valid under Michigan
law. In the event this claim is disallowed, I accept full responsibility for the payment of tax, penalty and any accrued interest, including, if necessary,
reimbursement to the vendor for tax and accrued interest.
Business Name
Type of Business (see codes on page 2)
Business Address
City, State, ZIP Code
Business Telephone Number (include area code)
Name (Print or Type)
Signature and Title
Date Signed
City of Traverse City
05
400 Boardman Avenue
Traverse City, MI 49684
231-922-4430
William E. Twietmeyer
3372, Page 2
Instructions for completing Michigan Sales and Use Tax Certificate of Exemption
Purchasers may use this form to claim exemption from Michigan sales and use tax on qualified transactions. It is the Purchaser’s
responsibility to ensure the eligibility of the exemption being claimed. All claims are subject to audit. Non-qualified transactions are
subject to tax, statutory penalty and interest.
Sellers are required to maintain records, paper or electronic, of completed exemption certificates for a period of four years. Michigan
does not issue “tax exempt numbers” and a seller may not rely on a number for substitution of an exemption certificate. Other
documentation that sellers in the State of Michigan may accept are the Uniform Sales and Use Tax Certificate approved by the
Multistate Tax Commission, the Streamlined Sales and Use Tax Agreement Certificate of Exemption, the same information in another
format from the purchaser, or resale or exemption certificates or other written evidence of exemption authorized by another state or
country.
SECTION 1:
Place a check in the box that describes how you will use this certificate.
A) Choose “One-Time Purchase” and include the invoice number this certificate covers.
B) Choose “Blanket Certificate” if there is a “recurring business relationship.” This exists when a period of not more than 12 months
elapses between sales transactions between the seller and purchaser.
C) Choose “Blanket Certificate” and enter the expiration date (maximum four years) when there is a period of more than 12 months
between sales transactions.
Print the vendor’s name and address in the area provided.
SECTION 2:
Place a check in the box for “All items purchased” or choose “Limited to” and list the items that are covered by the exemption claim.
SECTION 3:
Place a check in the box that applies and provide the additional information requested for that exemption. The exemptions listed are
the most common. If the exemption you are claiming is not listed use “Other” and enter the qualifying exemption.
SECTION 4:
Use the number that describes your business or explain any other business type not provided.
01
Accommodations
09
Transportation
02
Agricultural
10
Utilities
03
Construction
11
Wholesale
04
Manufacturing
12
Advertising, newspaper
05
Government
13
Non-Profit Hospital
06
Rental or leasing
14
Non-Profit Educational
07
Retail
15
Non-Profit 501(c)(3) or 501(c)(4)
08
Church
16
Other
Print the name of the business, address, city, state and zip code. Sign and provide your title (i.e. owner, president, treasurer, etc.).
Provide your printed name and date the certificate.
DO NOT SEND THIS EXEMPTION CERTIFICATE TO THE DEPARTMENT OF TREASURY.
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Form 3372 (Rev. 08-12): Michigan Sales and Use (City of Traverse City)

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Completed 5 August 2020

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