DR 0511 (08/30/13) 
colorado department of revenue                                         *130511==19999*
Denver, CO  80261 - 0009

                               Affidavit for Colorado Sales  
                             Tax Exemption for Farm Equipment

  I affirm that I have reviewed the written standards on this affidavit and that the primary use of this purchase or lease 
will qualify for the Colorado sales tax exemption for farm equipment used directly and primarily in my for-profit farm, 
ranch or livestock production facility operation, or used at my dairy farm for the production of raw milk.

  I accept that I remain directly liable for the sales or use tax assessment, and any applicable penalty or  
interest, if my purchase is found to not qualify for the exemption, or if my purchase or lease is converted to a  
non-qualifying use. 

  I understand that the dealer may request this affidavit for every purchase or lease, or less frequently, but a minimum  
of every two years.

                                                   Please Print or Type
Customer Last Name                      First Name                     Middle Initial Colorado Driver License Number

Company Name (if applicable)                                           TIN or Colorado Tax Number (if applicable)

Address                                            City                                                   State Zip

Signature                                                                                  Date (MM/DD/YY)

Seller Business Name                                                   Colorado Sales Tax Account Number

Date of Sale* (MM/DD/YY)                Amount of Sale*                Invoice Number*

Dealer:  Where any dealer has a reasonable doubt            This affidavit must be retained for three years from the 
about either the primary use of the item they are selling   date the vendor files his or her sales tax return  
to a commercial farm or ranch, or whether the item          reporting the sale. The department may request a copy 
qualifies as a farm tractor, implement of husbandry,        of this  
irrigation equipment, or aircraft used in crop dusting, the affidavit at any time during that three year period. 
dealer cannot rely on this affidavit and must collect the 
sales tax. [§39-26-703 C.R.S.]. Any customer who must       *Sellers must either (1) show the details of the sale here 
pay the sales tax may claim a refund from the Depart-       on the affidavit blocks or (2) be able to tie this affidavit 
ment of Revenue on form DR 0137, providing such proof       back to every purchase the customer made that was tax 
of his farming operation expenses and income and the        emempted under this affidavit. 
use of the item as is appropriate. Illegible or incomplete 
affidavits cannot be accepted. Dealers who accept them 
risk liability for tax on the products.