Rev.

11/13

Form ST-12
Exempt Use Certificate
Massachusetts
Department of
Revenue

Vendor’s name

Address City/Town State Zip

I hereby certify that the property herein described is purchased or leased for the following indicated purpose and is exempt from the sales or
use tax pursuant to Massachusetts General Laws (MGL), Chapter 64H, section 6(i), (j), (r), (s) or (dd), or is prewritten computer software that
qualifies for Multiple Points of Use treatment.
The materials, tools or fuel will become an ingredient or component part of tangible personal property to be sold.
02 A The materials, tools or fuel will be consumed and used directly and exclusively in, or
01

B The machinery, and/or replacement parts thereof, will be used directly and exclusively in
1 agricultural production
2 commercial fishing
3 industrial plant in the actual manufacture, conversion or processing of tangible personal property to be sold
4 publishing a newspaper
5 operation of commercial radio broadcasting or television transmission
6 furnishing power to an industrial manufacturing plant
7 furnishing gas, water, steam or electricity when delivered to consumers through mains, lines or pipes
8 research and development by a manufacturing or research and development corporation under MGL, Ch. 63, sec. 38C or 42B
9 production of animals for research, testing or other purposes to promote human or animal well-being
10 other (explain)
Sales of equipment used directly in solar, wind-powered or heat pump systems to heat or provide energy needs of the person’s principal resi-
dence in the Commonwealth.
03

The fuel will be used in the operation of aircraft or railroads.

The heating fuel will be consumed or used directly and exclusively in heating an industrial plant where at least 75% of the building, location or
04

premises is used for the actual manufacture of tangible personal property to be sold.
05

Gas  Steam  Electricity (check one) will be consumed and used directly and exclusively in the actual manufacture of tangible personal
property to be sold or in the heating of the industrial plant provided at least 75% of the metered energy is used for the combination of such manu-
06

facturing or heating of the manufacturing area.

The tangible personal property is a production expense directly incurred in the production of a motion picture by a qualifying motion picture produc-
tion company and clearly and demonstrably incurred in the Commonwealth.
07

The tangible personal property is a production expense directly incurred in the production of a motion picture by an accredited film school student,
clearly and demonstrably incurred in the Commonwealth and related to a school film project
08

Multiple Points of Use Certificate. The prewritten computer software will be concurrently available for use in multiple tax jurisdictions. The pur-
chaser agrees to remit apportioned use tax to Massachusetts.
09

10 Pesticides purchased by a person licensed or certified as a pesticide applicator by the Dept. of Agricultural Resources under MGL, Ch. 132B.
Description of property (complete for any exemption claimed in line 1 or 2; attach statement if necessary)

Service location(s) of qualified property (complete for any exemption claimed in line 6)

Account number(s)

Full liability is hereby assumed for the payment of any sales or use tax due in the event that the property purchased is used for any purpose other than
that herein certified. This certificate shall be considered a part of each order unless revoked in writing. All purchase orders under this certificate will clearly
indicate that they represent exempt use purchases.
Signed under the penalties of perjury.
Signature Title

Name of company

Address City/Town State Zip

Date Federal Identification number (if applicable)

Check applicable box:  Single purchase certificate  Blanket certificate

 Form ST-12 Instructions
A contractor purchasing property exempt under MGL chapter 64H,
Certain consumers may not be required to pay a sales tax if the section 6(r) or (s), may sign and present this form to its vendor. The
General Information

property they purchase is to be used in a manner which exempts contractor bears the burden of proof of demonstrating on audit that
it from taxation. the items purchased are or will be used in an exempt manner. In the
event that the items do not qualify for exemption under section 6(r)
If tangible personal property, including fuel, gas, steam or electric-
or (s), the contractor will be liable for the tax. An exempt use cer-
ity is purchased and that purchase qualifies for an exemption from
tificate furnished by the contractor’s customer to the contractor will
the sales or use tax, the purchaser may present an exempt use
not relieve the contractor from liability. See DD 07-6, “Exemptions
certificate to the vendor to certify that the property will be used in
under G.L. c. 64H, sec. 6(r) and sec. 6(s)” for further information.
an exempt manner. The burden of proving that a sale of tangible
personal property by any vendor is exempt from tax is on the ven-
dor, unless the vendor accepts from the purchaser a certificate This form is not to be used by an exempt organization (use Form
Notice to Purchasers

declaring that the property is exempt from tax. The Multiple Points ST-5), or to claim the exemption for containers used to transport
of Use Certificate claimed on line 9 is only applicable to prewritten food or drink off premises (use Form ST-12EC), or to claim the
computer software that will be concurrently available for use in small business energy exemption (use Form ST-13). For further
multiple tax jurisdictions. information on the proper form to use to claim an exemption for
the purchase of utilities and fuel see DD 92-3.
The vendor must make sure that the certificate is completed prop- If a purchaser makes any use of the property other than an exempt
Notice to Vendors

erly and signed before accepting it. use, such property will be subject to the Massachusetts sales or
use tax, as of the time the property is first used.
An exempt use certificate relieves the vendor from the burden of
proof only if it is taken in good faith from a purchaser who, at the For any exemption claimed in line 1 or 2, the purchaser must pro-
time of purchase, intends to use the property in an exempt man- vide a description of the exempt property. For any exemption
ner, or is unable to ascertain at the time of purchase that it will be claimed in line 6 for the purchase of gas, steam or electricity, the
used in an exempt manner. purchaser must provide the service locations of the qualified prop-
erty and utility account numbers. Attach an additional statement if
A Multiple Points of Use Certificate claimed on line 9 relieves the
more space is needed.
vendor from the obligation to collect, pay, or remit the applicable tax
on sales of prewritten software. A purchaser submitting a Multiple Points of Use Certificate by
checking line 9 agrees to report and remit the applicable sales or
The exemption claimed on line 10 for sales to a person licensed or
use tax to the jurisdictions where the software will be used, using
certified as a pesticide applicator by the Department of Agricultural
any reasonable, but consistent and uniform, method of apportion-
Resources under MGL, Ch. 132B only applies to sales of pesticides,
ment that is supported by the purchaser’s business records, as
including insecticides, herbicides, fungicides, miticides and all mate-
they exist at the time a return is filed. See TIR 05-15.
rials registered with the Environmental Protection Agency as pesti-
cides under Federal Insecticide, Fungicide and Rodenticide Act as If at any time a business that has presented this certificate ceases
well as other pesticides commonly regarded in the same category to qualify for the exemption, it must revoke in writing the Form ST-
and for the same purpose. See TIR 08-8 for more information. 12 it has given to its vendor(s).
The vendor must retain this certificate as part of his/her tax rec- For further information regarding the acceptance or use of exempt
ords. For further information regarding the requirements for retain- use certificates see Massachusetts Regulation, 830 CMR 64H.8.1.
ing records, see Massachusetts Regulation, 830 CMR 62C.25.1.
Warning: Willful misuse of this certificate may result in crimi-
nal tax evasion penalties of up to one year in prison and
This form may be used by a contractor when purchasing or leasing $10,000 ($50,000 for corporations) in fines.
Notice to Contractors

tangible personal property from a vendor in connection with fulfilling

If you have any questions about the acceptance or use of this cer-
a contract with its customer if the property will be used for one of
tificate, please contact: Massachusetts Department of Revenue,
the exempt uses described in Massachusetts General Laws (MGL)
Customer Service Bureau, PO Box 7010, Boston, MA 02204;
chapter 64H, section 6(r) or (s), which include the following: use di-
(617) 887-MDOR, or toll-free in-state 1-800-392-6089.
rectly and exclusively in an industrial plant in the actual manufac-
ture of tangible personal property to be sold; in the furnishing of
power to an industrial manufacturing plant; in the furnishing of gas,
water, steam or electricity when delivered to consumers through
mains, lines or pipes; in research and development by a manufac-
turing corporation or research and development corporation; in ag-
ricultural production; in commercial fishing.

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