PENNSYLVANIA EXEMPTION CERTIFICATE This …

RE V-1220AS + (1-07) PENNSYLVANIA EXEMPTION . CERTIFICATE this formcannot be used to CHECK ONE: obtain a SalesTax License Number,PTA License Number STATE OR LOCAL SALES AND USE TAX. COMMONWEALTH OF PENNSYLVANIA . or ExemptStatus. STATE OR LOCAL HOTEL OCCUPANCY TAX. DEPARTMENT OF REVENUE. BUREAU OF BUSINESS TRUST FUNDTAXES PUBLIC TRANSPORTATION ASSISTANCE TAXES AND FEES (PTA). PO BOX 280901 VEHICLE RENTAL TAX (VRT) Read Instructions HARRISBURG, PA 17128-0901. (Please Print or Type) On Reverse Carefully this FORM MAY BE PHOTOCOPIED VOID UNLESS COMPLETE INFORMATION IS SUPPLIE D. CHECK ONE: PENNSYLVANIA TAX UNIT EXEMPTION CERTIFIC ATE (USE FOR ONE TRANSACTION). PENNSYLVANIA TAX BLANKET EXEMPTION CERTIFIC ATE (USE FOR MULTIPLE TRANSACTIONS). Nameof Seller, Vendor, or Lessor Street City State ZIP Code NOTE: Do not use this form for claiming an EXEMPTION on the registration of a vehicle. To claim an EXEMPTION from tax for a motor vehicle, trailer, semi-trailer or tractor with the PA Department of Transportation, Bureau of Motor Vehicles, use one of the following forms: FORM MV-1 Application for CERTIFICATE of Title (first time registrations).

do not write in this box check one: pennsylvan i atx un ex empt on cert f c (us ef or ntransacti ) pennsylvania tax blanket exemption certificate (use for multiple transactions)

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