Arizona Form 
                                                        Transaction Privilege Tax Exemption Certificate
                               5000
 •     Do not use Form 5000 to claim sale for resale.  Use Form 5000A.
 •     Do not use Form 5000 if you are a non-TPT licensed contractor.  Use Form 5000M.
 This  Certificate  is  prescribed  by  the  Department  of  Revenue  pursuant  to  A.R.S.  §  42-5009.  The  purpose  of  the 
 Certificate is to document and establish a basis for state and city tax deductions or exemptions. It is to be filled 
 out completely by the purchaser and furnished to the vendor at the time of the sale.  The vendor shall retain 
 this Certificate for single transactions or for the specified period as indicated below. Incomplete Certificates are 
 not  considered  to be  accepted  in  good  faith. Only  one  category of  exemption  may  be  claimed on  a  Certificate.
 A.  Purchaser’s Name and Address:                                      B.  Check Applicable Box:
 Purchaser’s Name                                                        Single Transaction Certificate
                                                                         Period From                           Through  
 Address                                                                (You must choose specific dates for which the certificate will be valid. You 
                                                                        are  encouraged  not  to  exceed  a  12  month  period.  However,  a  certificate  will  be 
                                                                        considered to be accepted in good faith for a period not to exceed 48 months if the 
 City                                   State           ZIP Code        vendor has documentation the TPT license is valid for each calendar year covered 
                                                                        in the certificate.)
 Purchaser’s Email (Optional)                                           Purchaser’s Telephone Number (Optional)

 Vendor’s Name

 C.  Choose one transaction type per Certificate:
  Transactions with a Business                                          Transactions with Native Americans, Native American 
                                                                          Businesses and Tribal Governments (See reason #14.)
 Arizona Transaction Privilege Tax (TPT) License Number                 Tribal Business License Number  OR    Tribal Number

 SSN / EIN                                                              Name of Tribe                           Tribal Government 
                                                                                                                
 Other Tax License Number                                                Transactions with a U.S. Government entity 
                                                                              (See reasons #9 and #10.)
 If no license, provide reason:
                                                                         Transaction with a Foreign Diplomat  (See reason #15.)
 Precise Nature of Purchaser’s Business.

 D.  Reason for Exemption:  
 Check the box indicating one of the more common exemptions provided below, or use Box 16 or 17 to cite the appropriate 
 authority for  another exemption  (deduction).  Refer to        www.azdor.gov/Forms/TransactionPrivilegeTax.aspx  for  a 
 complete list of state and city exemptions (deductions) and the business classes (codes) under which the deductions apply. 
  1. Tangible personal property to be leased or rented in the ordinary course of the purchaser’s licensed business.
  2. Tangible personal property to be incorporated into a taxable contracting project, or a maintenance, repair, replacement or alteration 
      project. 
  3. Food, drink, or condiments purchased by a restaurant business.
  4. Pipes or valves four inches in diameter or greater to be used for transportation of oil, natural gas, artificial gas, water or coal slurry.
  5. Railroad rolling stock, rails, ties, and signal control equipment.
  6. Machinery and equipment sold or leased and used directly in the following business activities:
       Manufacturing, processing or fabricating.        Job printing.          Refining or metallurgical operations. 
       Extraction of ores or minerals from the earth for commercial purposes. 
       Extraction of, or drilling for, oil or gas from the earth for commercial purposes.
  7. Income Producing Capital Equipment to be leased.  NOTE:  Cities only - See M.C.T.C. 110 for definitions.
  8. Food, drink or condiments for consumption within the premises of any prison, jail or other institution under the jurisdiction of the state 
      department of corrections, the department of public safety, the department of juvenile corrections or a county sheriff.  Food, drink, 
      condiments or accessories purchased by a school district for consumption at a public school within the district during school hours. 
  9. Tangible personal property sold or leased directly to the United States Government or its departments or agencies by a manufacturer, 
      modifier, assembler or repairer.  (Retail, personal property rental and mining classifications only.)
   10. Fifty percent of the gross proceeds or gross income from the sale of tangible personal property directly to the United States 
      Government or its departments or agencies.  (Retail classification only.) 
                                                                                                                Continued on page 2 
 ADOR 10308 (9/21)  

Your Name (as shown on page 1)                                                                                  Arizona Transaction Privilege Tax License Number

 11.  Electricity, natural gas or liquefied petroleum gas sold to a qualified manufacturing or smelting business.  A manufacturing or 
      smelting business that claims this exemption authorizes the release by the vendor of the information required to be provided 
      to the Department of Revenue pursuant to A.R.S. § 42-5063(C)(6).                                  NOTE:  It is recommended that the purchaser attach the 
      worksheet from the Transaction Privilege Procedure (TPP 18-1). (Utilities classification only.) (Not available for all Cities.)
 12.  Electricity or natural gas to a business that operates an international operations center in this state and that is certified by the 
      Arizona Commerce Authority.  NOTE:  Certification must be attached.  (Utilities classification only.) (Not available for all Cities.)
 13.  Computer data center equipment sold to the owner, operator or qualified colocation tenant of a computer data center that is 
      certified by the Arizona Commerce Authority pursuant to A.R.S. § 41-1519.                              NOTE:  Equipment must qualify and certification 
      must be attached.
 14.  Sale or lease  of  tangible personal property to  affiliated Native Americans if  the  order is  placed from  and delivered to  the 
      reservation.  NOTE:  The vendor shall retain adequate documentation to substantiate the transaction.
 15.  Foreign diplomat.  NOTE:  Limited to authorization on the U.S. Department of State Diplomatic Tax Exemption Card.  The vendor 
      shall retain a copy of the U.S. Department of State Diplomatic Tax Exemption Card and any other documentation issued by the 
      U.S. Department of State.  Motor vehicle purchases or leases must be pre-authorized by the Office of Foreign Missions (“OFM”). 
      See “Vehicle Tax Exemption” at www.state.gov/ofm/tax/
 16. Other* Deduction:  Cite the Arizona Revised Statutes authority for the deduction.  A.R.S. §                                     
      Description: 

 17. Other* Cities Deduction:  Cite the Model City Tax Code authority for the deduction.  M.C.T.C. §                                 
      Description: 

*Refer to www.azdor.gov/TransactionPrivilegeTax(TPT)/RatesandDeductionCodes.aspx for a complete list of state and city 
 exemptions (deductions) and the business classes (codes) under which the deductions apply.

E.  Describe the tangible personal property or service purchased or leased and its use below.   
 (Use additional pages if needed.)

F.  Certification
A vendor that has reason to believe that this Certificate is not accurate or complete will not be relieved of the burden of 
proving entitlement to the exemption.  A vendor that accepts a Certificate in good faith will be relieved of the burden of proof 
and the purchaser may be required to establish the accuracy of the claimed exemption.  If the purchaser cannot establish 
the accuracy and completeness of the information provided in the Certificate, the purchaser is liable for an amount equal to 
the transaction privilege tax, penalty and interest which the vendor would have been required to pay if the vendor had not 
accepted the Certificate.  Misuse of this Certificate will subject the purchaser to payment of the A.R.S. § 42-5009 amount equal 
to any tax, penalty or interest.  Willful misuse of this Certificate will subject the purchaser to criminal penalties of a felony 
pursuant to A.R.S. § 42-1127(B).

I, (print full name)                                                                                         , hereby certify that these transactions are 
exempt from Arizona transaction privilege tax and that the information on this Certificate is true, accurate and complete.  
Further, if purchasing or leasing as an agent or officer, I certify that I am authorized to execute this Certificate on behalf of 
the purchaser named above.

SIGNATURE OF PURCHASER                                                          DATE                         TITLE
ADOR 10308 (9/21)                                                                                                 Page 2 of 2
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