Fillable Instructions for State of Colorado Afdavit of Exempt

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Instructions for State of Colorado Afdavit of Exempt

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1
Instructions for State of Colorado Afdavit of Exempt Sale
These instructions are specic to the State of Colorado in which this purchase has been made. Qualifying for an
exemption may be different for each local jurisdiction, and these instructions are not intended to set forth the requirements
of any local jurisdiction.
General Instructions
Purpose of Form
This form is used to certify to sellers that a purchase
qualies for exemption under Title 39, Article 26 of the
Colorado Revised Statutes.
For Sellers, accepting and keeping this document helps
you get correct information about the purchaser, which
helps you prove this is an exempt sale during a tax audit.
For Purchasers, completing this document and giving it to
a seller helps to speed up your purchase process.
_______________________________________________
Reminders
Furnish to seller. This form should be furnished to the
seller charging the tax. Do not send this form to the State
of Colorado. This form is not for organizations to request
certication of their tax exempt status.
Direct payment required. Purchases must be billed to and
paid directly by the funds of the organization or agency in
order to qualify for exemption. Payment in cash (without
a purchase order) or by personal check or personal credit
card disqualies a purchase from exemption even if the
purchaser is subsequently reimbursed. Purchases made
on credit cards issued by the organization, but where the
cardholder receives and pays the bill and is subsequently
reimbursed, also do not qualify for exemption.
Reimbursement disqualies exemption. If the
organization or agency will be reimbursed, in whole or
in part, the purchase is disqualied from exemption. For
example, the purchase of food for a banquet for which the
organization sells tickets as a fundraiser would not qualify
for exemption.
Disputed tax must be collected. If there is a dispute
between the purchaser and the seller as to whether
tax applies, the seller that collects the tax must give
the purchaser a receipt showing the tax collected. The
purchaser may apply to the applicable municipality directly
for a refund by ling a Claim for Refund form along with the
appropriate documentation.
Signature required. The individual making the purchase
must sign and date the form at the bottom. A separate
afdavit is required for each transaction. General purchaser
or store information may be completed in advance and kept
on le by the seller or purchaser for ease of use.
Purchaser Instructions
Purchase details. Identify the accurate qualied exemption
reason and complete the required information for that
exemption.
Purchaser information. Print the legal name of the
organization or agency. Governmental agencies should
include both the name of the government and the
department or agency, for example, US Department of
Transportation, Colorado Department of Education, or
Adams County Human Services. Abbreviations such as
“Dept.” are acceptable but do not use acronyms. List the
organization’s or agency’s mailing address, municipality,
state, and zip code.
Declaration of afant. The individual making the purchase
on behalf of the exempt organization or agency (the afant)
must complete the declaration.
Separate form required. A separate afdavit is required
for each transaction. For ease of use, Purchase Details and
Purchaser Information may be completed in advance and
the partially completed form kept on le by the purchaser
for completion at time of each transaction.
Signature. You are swearing, under penalty of perjury,
to the accuracy of the statements made in this afdavit.
Carefully read and ensure that you understand each item
before signing this afdavit. After reviewing the form for
accuracy, sign and date the form. Furnish this form to the
seller. Do not send a copy to the State of Colorado.
Seller Instructions
Sellers have the burden of proving that a transaction
was properly exempted. If an exemption is subsequently
disallowed by the State of Colorado, you (the seller) could
be liable for the tax plus penalties and interest. This form
is provided to help you determine if a sale qualies for
exemption. The sale is not exempt from taxes simply
because this afdavit is completed. The responsibility
for proper collection of taxes remains with the seller. You
are encouraged to obtain this form for each transaction
and complete all of the information in the lower Seller
Verication section.
(continued on next page)
DR 5002 (12/26/18)
COLORADO DEPARTMENT OF REVENUE
2
Resale/Wholesale transactions – To qualify as an exempt
purchase for resale or wholesale, the items purchased
must be reasonably deemed to be for sale in the ordinary
course of business of the purchaser. For resale/wholesale
transactions the seller is required to not only collect the
applicable license information, but to exercise sound
judgment and a reasonable amount of skepticism to
ensure the items purchased are reasonably for sale in the
purchaser’s ordinary course of business. For example, a
restaurant would not be allowed to purchase dish soap
for resale because restaurants do not sell dish soap in the
ordinary course of business, but rather use the dish soap in
the operation of the business.
The afdavit needs to be completed in its entirety. Be
sure information is complete, accurate and legible. Review
the information, and particularly verify that the driver license
number and purchaser’s name are correct. Also, be
sure that the digits that are required from the credit cards
are correct. Only record and keep those digits from the
credit card that the afdavit requires. The signature of the
purchaser should be the same as on the driver license.
Sellers should review guidance on accepting
government credit cards. Not all cards qualify for
exemption, even though they bear certain characteristics of
exemption. See FYI Sales 63 for more information.
Collection of this form does not provide a safe-harbor
from disallowance by the State of Colorado. Retain this
form for at least 3 years.
State of Colorado Specic Instructions
Charitable & Religious Organizations – The State of
Colorado provides an exemption for organizations that
have been certied exempt under 501(c)(3) of the Internal
Revenue Code. A Certicate of Exemption is issued to the
organization when granted exemption by the Colorado. A
copy of the Certicate of Exemption should be retained with
this completed Afdavit. For organizations located outside
of Colorado, a copy of the letter from the IRS certifying
exemption as a 501(c)(3) organization may be accepted
in lieu of a State issued Certicate of Exemption. See FYI
Sales 2 for more information.
Government and Diplomatic Exemption – Please see
FYI Sales 63 for information related to government and
diplomatic purchase exemptions.
Wholesale/Resale Transactions - A copy of the State
Wholesale or Retail License should be retained with this
completed afdavit. See FYI Sales 1 for more information.
Out of State Exempt Entities – This afdavit may be used
by an out of state charitable organization or government
entity as long as both of the following are met:
Payment is made from the organization’s funds and no
reimbursement will be made to the organization through
direct payment, collection or donation from any person(s)
for the use or consumption of the goods or services;
and The items or services purchased are used in
conjunction with the organization’s regular religious,
charitable, educational or governmental activities.
See FYI Sales 3 for more information.
Instructions for State of Colorado Afdavit of Exempt Sale
(continued)
These instructions are specic to the State of Colorado in which this purchase has been made. Qualifying for an
exemption may be different for each local jurisdiction, and these instructions are not intended to set forth the requirements
of any local jurisdiction.
Standard Colorado Afdavit of Exempt Sale
This form is required by the State of Colorado for any transaction on which an exemption from state tax is claimed for
charitable and government entities. The seller is required to maintain a completed form for each tax-exempt sale.
Furnish this form to the seller. Do not return this form to the State of Colorado.
Purchase Details
Purchase for resale - or - Purchase for wholesale (see instructions)
State license number (not FEIN number): ____________________ Issuing state _____ Expiration _________
(Attach a copy of state license)
I afrm items purchased are for resale/wholesale in the ordinary course of business. Initial _____________
Purchase by religious or charitable organization (exemptions may vary by jurisdiction)
State tax-exempt number (not FEIN number): _________________________
(Attach a copy of state exemption certicate)
Payment information (required to meet one of the following):
Paid by cash and accompanied by a purchase order from the organization
Paid by check drawn on funds of the exempt organization
Paid by purchasing card bearing information of the exempt organization
The embossed name of the card is:________________________________________
Paid by commercial card not a personal credit card - card’s last four digits: __________
Purchase by federal, state, or local government
Credit card number (rst six and last four only:________-_______xx-xxxx-_________.
Federal government (payment information - required to meet one of the following):
GSA SmartPay3 card – eet card with picture of a road and ag
GSA SmartPay3 card – purchase card with picture of a keyboard and ag
GSA SmartPay3 card – travel card with picture of an airplane and ag
GSA SmartPay3 card – integrated card with picture of an eagle and ag
Dept of Interior agency issued card – agency name _______________________________________.
State and local government (payment information - required to meet one of the following):
Paid by check issued by and drawn on funds from the government agency
Paid by government purchase card as designated on the card
State tax-exempt number printed on the card (Colorado only): _____________________.
Check if the card states “for ofcial state use only” or “tax exempt”
Purchase by foreign and diplomatic exemptions (required to meet the following):
Purchaser presents a state department issued card with the name/photo of the bearer on the card.
If presented with this card, documentation of form of payment is not required (excluding mission card).
Purchaser Information
Legal Name of Company/Organization/Agency Name Purchaser Name (Printed)
Address City State Zip + 4
Phone State/Driver License # Description of Normal Course of Business
Under penalty of perjury, I swear or afrm that the information on this form is true and correct as to every material matter. I afrm that the items purchased
tax-exempt will be used for ofcial business of the above-named organization or agency. I accept that I remain directly liable for the taxes and any
applicable penalty or interest if my purchase is found to not qualify for the exemption or if the information asserted in this form is deemed fraudulent.
Signature Date
Seller Verication
Seller Name Location # Date Transaction ID Employee ID# / Initials
Description of Items Purchased or Attach Duplicate Receipt/Invoice Exempted Amount of Purchase
DR 5002 (12/26/18)
COLORADO DEPARTMENT OF REVENUE
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Instructions for State of Colorado Afdavit of Exempt

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Completed 23 August 2021

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