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Instructions for Standard Municipal Home Rule Affidavit of Exempt Sale
These instructions are specific to the jurisdiction in which this purchase has been made.
Qualifying for an exemption may be different for each jurisdiction, and these instructions are not
intended to set forth the requirements of any jurisdiction other than the one indicated.
Purpose of Form Sellers have the burden of proving that a transaction was
properly exempted. If an exemption is subsequently disallowed
This form is used to certify to sellers that a purchase qualifies for by the municipality, you (the seller) could be liable for the tax plus
exemption under Fort Collins Municipal Code (FCMC) Chapter 25. penalties and interest. This form is provided to help you
determine if a sale qualifies for exemption. The sale is not
exempt from taxes simply because this affidavit is completed.
Reminders The responsibility for proper collection of taxes remains with the
Furnish to seller. This form should be furnished to the seller seller. You are encouraged to obtain this form for each
charging the tax. Do not send this form to the taxing jurisdiction. transaction and complete all of the information in the lower Seller
This form is not for organizations to request certification of their tax Verification section.
exempt status. Resale/Wholesale transactions – To qualify as an exempt
Direct payment required. Purchases must be billed to and paid purchase for resale or wholesale, the items purchased must be
directly by the funds of the organization or agency in order to reasonably deemed to be for sale in the ordinary course of
qualify for exemption. Payment in cash (without a purchase order) business of the purchaser. For resale/wholesale transactions the
or by personal check or personal credit card disqualifies a seller is required to not only collect the applicable license
purchase from exemption even if the purchaser is subsequently information, but to exercise sound judgment and a reasonable
reimbursed. Purchases made on credit cards issued by the amount of skepticism to ensure the items purchased are
organization, but where the cardholder receives and pays the bill reasonably for sale in the purchaser’s ordinary course of
and is subsequently reimbursed, also do not qualify for exemption. business. For example, a restaurant would not be allowed to
purchase dish soap for resale because restaurants do not sell
Reimbursement disqualifies exemption. If the organization or dish soap in the ordinary course of business, but rather use the
agency will be reimbursed, in whole or in part, the purchase is dish soap in the operation of the business.
General Instructions disqualified from exemption. For example, the purchase of food for Seller Instructions
a banquet for which the organization sells tickets as a fundraiser The affidavit needs to be completed in its entirety. Be sure
would not qualify for exemption. information is complete, accurate and legible. Review the
information, and particularly verify that the driver’s license
Disputed tax must be collected. If there is a dispute between the number and purchaser’s name are correct. Also, be sure that the
purchaser and the seller as to whether tax applies, FCMC Section digits that are required from the credit cards are correct. Only
25-73 requires the seller to collect the tax. The seller should give record and keep those digits from the credit card that the affidavit
the purchaser a receipt showing the tax collected. The purchaser requires. The signature of the purchaser should be the same as
may apply to the applicable municipality directly for a refund by on the driver’s license.
filing a Claim for Refund form along with the appropriate
documentation within 60 days of the date of the purchase. Sellers should review guidance on accepting government
credit cards. Not all cards qualify for exemption, even though
Signature required. The individual making the purchase must they bear certain of the listed characteristics.
sign and date the form at the bottom. A separate affidavit is
required for each transaction. General purchaser or store Collection of this form does not provide a safe-harbor from
information may be completed in advance and kept on file by the disallowance by the municipality. Retain this form for at least 3
seller or purchaser for ease of use. years.
Purchase details. Identify the accurate qualified exemption Resale/Wholesale – The seller must obtain a copy of the
reason and complete the required information for that exemption. purchaser’s State of Colorado and applicable municipal resale or
Purchaser information. Print the legal name of the organization wholesale license or license number. To qualify as a tax exempt
or agency. Governmental agencies should include both the name resale/wholesale purchase the seller must exercise due care and
of the government and the department or agency, for example, US good faith to ensure the item/service sold is of a type normally
Department of Transportation, Colorado Department of Education, resold in the purchaser’s usual course of business. When in
or Adams County Human Services. Abbreviations such as “Dept.” doubt, it is the seller’s responsibility to collect tax.
are acceptable but do not use acronyms. List the organization’s or Charitable/Religious – To make purchases that are exempt
agency’s mailing address, municipality, state, and zip code. from City of Fort Collins tax, charitable/religious organizations
Declaration of affiant. The individual making the purchase on must provide a copy of the City of Fort Collins tax exemption
behalf of the exempt organization or agency (the affiant) must license or number to the seller.
complete the declaration.
Separate form required. A separate affidavit is required for each Government – The seller must obtain a copy of the purchaser’s
transaction. For ease of use, Purchase Details and Purchaser State of Colorado exemption certificate or certificate number.
Information may be completed in advance and the partially Government sales include sales to public schools. The City does
completed form kept on file by the purchaser for completion at not issue a separate license for government/school entities.
time of each transaction.
Constructions Materials – If a city tax has been prepaid on a
Purchaser Instructions Signature. You are swearing, under penalty of perjury, to the building permit, building materials purchased for the permitted
accuracy of the statements made in this affidavit. Carefully read project will be exempt from City of Fort Collins tax. The seller
and ensure that you understand each item before signing this Jurisdiction Specific Instructions must maintain a copy of the building permit.
affidavit. After reviewing the form for accuracy, sign and date the
form. Furnish this form to the seller. Do not send a copy to the For the full text of applicable definitions and exemptions refer to
municipality. the FCMC Chapter 25. For assistance contact the Tax Division at
970-221-6780 or visit www.fcgov.com/salestax.
Page 2 of 2 Revised 5/30/2014
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