I further certify that we are engaged in business as a: c Wholesaler c Retailer c Manufacturer c Lessor
Description of Product Sold, Leased, or Rented
of _____________________________________________________________________________________________________________________
My Nebraska Sales Tax ID Number is 01-_________________________________.
If none, state the reason _____________________________________________________________________________________________________,
or Foreign State Sales Tax Number__________________________________________ State __________________________________________.
for Sales Tax Exemption
13
Nebraska Resale or Exempt Sale Certificate
FORM
Name and Mailing Address of Seller
Name
Street or Other Mailing Address
City State Zip Code
Name and Mailing Address of Purchaser
Name
Legal Name
Street or Other Mailing Address
City State Zip Code
Check Type of Certificate
c Single Purchase If single purchase is checked, enter the related invoice or purchase order number ______________________________________.
c Blanket If blanket is checked, this certicate is valid until revoked in writing by the purchaser.
Section B Nebraska Exempt Sale Certificate
Section A — Nebraska Resale Certificate
Any purchaser, agent, or other person who completes this certificate for any purchase which is not for resale, lease, or rental in the regular course of the
purchaser’s business, or is not otherwise exempted from sales and use taxes is subject to a penalty of $100 or ten times the tax, whichever amount is larger, for
each instance of presentation and misuse. With regard to a blanket certificate, this penalty applies to each purchase made during the period the blanket certificate
is in effect. Under penalties of law, I declare that I am authorized to sign this certificate, and to the best of my knowledge and belief, it is correct and complete.
sign
here
Authorized Signature Title Date
Section C For Contractors Only
c As an Option 1 or Option 3 contractor, I hereby certify that the purchase of building materials and xtures from the seller listed above are exempt
from Nebraska sales tax. My Nebraska Sales or Use Tax ID Number is: _____________________________________________________.
c Yes c No
Do not send this certificate to the Nebraska Department of Revenue. Keep it as part of your records.
Sellers cannot accept incomplete certificates.
The Department is committed to the fair administration of the Nebraska tax laws. It is unlawful to claim an exemption for purchases
of property or services that are subject to tax. Sellers are encouraged to notify the Department of any unlawful use of this form.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
Description of Items Sold
6-134-1970 Rev. 3-2018
Supersedes 6-134-1970 Rev. 10-2014
I hereby certify that the purchase, lease, or rental of ___________________________________________________________from the seller listed
above is exempt from the Nebraska sales tax as a purchase for resale, rental, or lease in the normal course of our business. The property or service will be
resold either in the form or condition in which it was purchased, or as an ingredient or component part of other property or service to be resold.
1. Purchase of building materials or fixtures.
2. Purchases made by an Option 2 contractor under a Purchasing Agent Appointment on behalf of_________________________
________________________________________.
The basis for this exemption is exemption category ______ (See the list of Exemption Categories and corresponding numbers on reverse side).
If exemption category 2 or 5 is claimed, enter the following information:
Description of Property or Service Purchased Intended Use of Property or Service Purchased
_____________________________________________________________ _______________________________________________________
If exemption category 3 or 4 is claimed, enter your Nebraska Certicate of Exemption State ID number. 05 -______________________________
If exemption category 6 is claimed, the seller must enter the following information and sign this form below:
Date of Seller’s Original Purchase Was tax paid when purchased by seller? Was item depreciable?
I hereby certify that the purchase, lease, or rental by the above purchaser is exempt from the Nebraska sales tax for the following reason:
Check One c Purchase for Resale (Complete Section A.) c Exempt Purchase (Complete Section B.) c Contractor (Complete Section C.)
(exempt entity)
Do not enter your Federal Employer ID Number.
c Yes c No
c As an Option 2 contractor, I hereby certify that the purchase of building materials and xtures from the seller listed above is exempt from
Nebraska sales tax pursuant to the attached Purchasing Agent Appointment and Delegation of Authority for Sales and Use Tax, Form 17.
Authorized Signature Name (please print)
Description of Property or Service Purchased
RESET FORM
PRINT FORM
Who May Issue a Resale Certificate. Purchasers are to give the
seller a properly completed Form 13, Section A, when making purchases
of property or taxable services that will subsequently be resold in the
purchaser’s normal course of business. The property or services must be
resold in the same form or condition as when purchased, or as an ingredient
or component part of other property that will be resold.
Who May Issue an Exempt Sale Certificate. Form 13, Section B,
may be completed and issued by governmental units or organizations that
are exempt from paying Nebraska sales and use taxes. See this list in the
Nebraska Sales Tax Exemptions Chart. Most nonprot organizations are
not exempt from paying sales and use tax. Enter the appropriate number
from “Exemption Categories” (listed below) that properly reects the basis
for your exemption.
For additional information about proper issuance and use of this certicate,
please review Reg-1-013, Sale for Resale – Resale Certificate, and
Reg-1-014, Exempt Sale Certicate.
Contractors. Contractors complete Form 13, Section C, part 1 or part 2
based on the option elected on the Contractor Registration Database.
To make tax-exempt purchases of building materials and xtures, Option
1 or Option 3 contractors must complete Form 13, Section C, Part 1. To
make tax-exempt purchases of building materials and xtures pursuant
to a construction project for an exempt governmental unit or an exempt
nonprofit organization, Option 2 contractors must complete Form 13,
Section C, Part 2. The contractor must also attach a copy of a properly
completed Purchasing Agent Appointment and Delegation of Authority for
Sales and Use Tax, Form 17, to the Form 13, and both documents must be
given to the supplier when purchasing building materials. See the contractor
information guides and Reg-1-017, Contractors, for additional information.
Also, see the Important Note under “Exemption Categories” number 3.
When and Where to Issue. The Form 13 must be given to the seller
at the time of the purchase to document why sales tax does not apply
to the purchase. The Form 13 must be kept with the seller’s records for
audit purposes.
Sales Tax Number. A purchaser who is engaged in business as a
wholesaler or manufacturer is not required to provide an ID number when
completing Section A. Out-of-state purchasers may provide their home state
sales tax number. Section B does not require a Nebraska ID number when
exemption category 1, 2, or 5 is indicated.
Fully Completed Resale or Exempt Sale Certificate. A fully
completed resale or exempt sale certificate is proof for the retailer
that the sale was for resale or is exempt. For a resale certicate to be
fully completed, it must include: (1) identification of the purchaser
and seller, type of business engaged in by the purchaser; (2) sales
tax permit number; (3) signature of an authorized person; and
(4) the date of issuance.
For an exempt sale certicate to be fully completed, it must include:
(1) identication of purchaser and seller; (2) a statement that the certicate
is for a single purchase or is a blanket certicate covering future sales;
(3) a statement of the basis for exemption, including the type of activity
engaged in by the purchaser; (4) signature of an authorized person; and
(5) the date of issuance.
Penalties. Any purchaser who gives a Form 13 to a seller for any purchase
which is other than for resale, lease, or rental in the normal course of the
purchaser’s business, or is not otherwise exempted from sales and use tax
under the Nebraska Revenue Act, is subject to a penalty of $100 or ten times
the tax, whichever is greater, for each instance of presentation and misuse.
In addition, any purchaser, or their agent, who fraudulently signs a Form 13
may be found guilty of a Class IV misdemeanor.
Exemption Categories
(Insert appropriate number from the list below in Section B)
1. Governmental units, identied in Reg-1-072, United States Government
and Federal Corporations; and Reg-1-093, Governmental Units.
Governmental units are not assigned exemption numbers.
Instructions
Sales to the U.S. government, its agencies, instrumentalities, and
corporations wholly owned by the U.S. government are exempt from
sales tax. However, sales to institutions chartered or created under
federal authority, but which are not directly operated and controlled by
the U.S. government for the benet of the public, generally are taxable.
Purchases by governmental units that are not exempt from Nebraska
sales and use taxes include, but are not limited to: governmental units
of other states; sanitary and improvement districts; rural water districts;
railroad transportation safety districts; and county historical societies.
2. Purchases when the intended use renders it exempt. See Nebraska Sales
Tax Exemption Chart.
3. Purchases made by organizations that have been issued a Nebraska Exempt
Organization Certificate of Exemption (Certificate of Exemption).
Reg-1-090, Nonprofit Organizations; Reg-1-091, Religious
Organizations; and Reg-1-092, Educational Institutions, identify these
organizations. These organizations are issued a Certicate of Exemption
with a state ID number which must be entered in Section B of Form 13.
Important Note: Nonprot educational institutions must be accredited
regionally or nationally and have their primary campus in Nebraska to be
exempt from sales and use tax. Also nonprot organizations providing
any of the types of health care or services that qualify to be exempt
must be licensed or certied by the Nebraska Department of Health and
Human Services (DHHS) to be exempt from sales and use taxes. There
is no sales and use tax exemption prior to these entities being accredited,
licensed, or certied. They CANNOT issue either a Resale or Exempt
Sale Certicate, Form 13, or a Purchasing Agent Appointment, Form 17,
to any retailer or contractor relating to purchases of building materials
for construction or repair projects performed prior to being accredited,
licensed, or certied. After an entity becomes accredited, licensed, or
certied upon completion of the construction project, it may submit a
Form 4.
Nonprofit health care organizations that hold a Certificate of
Exemption are exempt for purchases for use at their facility, or portion
of the facility, covered by the license issued under the Nebraska Health
Care Facility Licensure Act. Only specic types of health care facilities
and activities are exempt. Purchases of items for use at facilities that
are not covered under the license, or for any other activities that are
not specically exempt, are taxable. The exemption is not for the entire
organization that oers dierent levels of health care or other activities,
but is limited to the specic type of health care that is exempt. Purchases
for non-exempt types of health care are taxable.
4. Purchases of motor vehicles, trailers, semitrailers watercraft, and aircraft
used predominately as common or contract carrier vehicles; accessories
that physically become part of the common or contract carrier vehicle;
and repair and replacement parts for these vehicles. The exemption ID
number must be entered in Section B of the Form 13. An individual or
business that has been issued a common or contract carrier certicate of
exemption may only use it to purchase those items described above prior
to the expiration date on the certicate. The certicate of exemption
expires every 5 years. (See Nebraska Common or Contract Carrier
Information Guide).
5. Purchases of manufacturing machinery and equipment made by a
person engaged in the business of manufacturing, including repair
and replacement parts or accessories, for use in manufacturing. (See
Reg-1-107, Manufacturing Machinery and Equipment Exemption).
6. Occasional sales of used business or farm machinery or equipment
productively used by the seller as a depreciable capital asset for more
than one year in his or her business. The seller must have previously
paid tax on the item being sold. The seller must complete, sign, and
give the Exempt Sale Certicate to the purchaser. (See Reg-1-022,
Occasional Sales). The Form 13 must be kept with the purchaser’s
records for audit purposes.