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Form                                                                                                 Wisconsin Dept of Revenue
                                                                                                              Nexus Unit  2‑233
                                   Affidavit of Exempt Sales
  A-006                                                                                                       PO Box 8906
                                                                                                        Madison WI  53708‑8906

                     phone:  (608) 266‑3969      •FAX:  (608) 266‑5464       website: •revenue.wi.gov

The Secretary of Revenue is required to certify to the Secretary of Administration a list of vendors and their affiliates who are:
  •  not registered to collect and remit Wisconsin sales and use tax, unless all sales are exempt, or 
  •  registered, but do not collect or remit such taxes.
Wisconsin state agencies and authorities may not purchase materials, supplies, equipment or contractual services from vendors 
and affiliates who have been “certified” to the Secretary of Administration.
“Affiliate” means a person that controls, is controlled by, or is under common control with another person. “Control” means to 
own, directly or indirectly, more than 10% of the interest in, or voting securities of a business.
Any vendor or affiliate that only makes sales that are not subject to Wisconsin sales or use tax should complete the affidavit 
below.  This certifies that all sales in Wisconsin are exempt from Wisconsin sales and use tax. Examples of exempt sales include:
  •  sales for resale
  •  sales to governmental units
  •  sales to exempt organizations
  •  sales of non‑taxable services
Exempt sales do not include sales of tangible personal property or taxable services not taxed solely because the vendor or 
affiliate does not have activity in Wisconsin that requires them to collect and remit sales and use tax.
Any vendor or affiliate having only exempt sales in Wisconsin is not required to register to collect and remit Wisconsin sales or 
use tax.

Legal name

Business name (DBA)

Mailing address

Federal ID number

Type of property sold

Type of services sold

                                                              certifies that all Wisconsin sales of its property and 
                     Company name                             services are exempt under ch. 77, Wis. Stats.

I certify that, to the best of my knowledge, the above information is accurate and complete.

Completed by  (type or print)                                 Title

Signature                                                     Date

(       )
Telephone number                                              Email address

A-006 (R. 12-16)