Massachusetts Exempt Use Certificate

Exempt Use Certificate 
ST-12
Rev. 11/13

Form ST-12
Exempt Use Certificate

Vendor’s name

City/Town

Address

Massachusetts
Department of
Revenue

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.
01
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
B The machinery, and/or replacement parts thereof, will be used directly and exclusively in
1
2
3
4
5

03
04
05
06

07
08
09
10

6
7
8
9
10

agricultural production
commercial fishing
industrial plant in the actual manufacture, conversion or processing of tangible personal property to be sold
publishing a newspaper
operation of commercial radio broadcasting or television transmission

furnishing power to an industrial manufacturing plant
furnishing gas, water, steam or electricity when delivered to consumers through mains, lines or pipes
research and development by a manufacturing or research and development corporation under MGL, Ch. 63, sec. 38C or 42B
production of animals for research, testing or other purposes to promote human or animal well-being
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 residence in the Commonwealth.
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
premises is used for the actual manufacture of tangible personal property to be sold.
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 manufacturing 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 production company and clearly and demonstrably incurred in the Commonwealth.
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
Multiple Points of Use Certificate. The prewritten computer software will be concurrently available for use in multiple tax jurisdictions. The purchaser agrees to remit apportioned use tax to Massachusetts.
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

Date

Federal Identification number (if applicable)

Check applicable box: 

Single purchase certificate 

Blanket certificate

State

Zip

Form ST-12 Instructions

Certain consumers may not be required to pay a sales tax if the
property they purchase is to be used in a manner which exempts
it from taxation.

General Information

If tangible personal property, including fuel, gas, steam or electricity is purchased and that purchase qualifies for an exemption from
the sales or use tax, the purchaser may present an exempt use
certificate to the vendor to certify that the property will be used in
an exempt manner. The burden of proving that a sale of tangible
personal property by any vendor is exempt from tax is on the vendor, unless the vendor accepts from the purchaser a certificate
declaring that the property is exempt from tax. The Multiple Points
of Use Certificate claimed on line 9 is only applicable to prewritten
computer software that will be concurrently available for use in
multiple tax jurisdictions.

The vendor must make sure that the certificate is completed properly and signed before accepting it.

Notice to Vendors

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
time of purchase, intends to use the property in an exempt manner, or is unable to ascertain at the time of purchase that it will be
used in an exempt manner.

A Multiple Points of Use Certificate claimed on line 9 relieves the
vendor from the obligation to collect, pay, or remit the applicable tax
on sales of prewritten software.

The exemption claimed on line 10 for sales to a person licensed or
certified as a pesticide applicator by the Department of Agricultural
Resources under MGL, Ch. 132B only applies to sales of pesticides,
including insecticides, herbicides, fungicides, miticides and all materials registered with the Environmental Protection Agency as pesticides under Federal Insecticide, Fungicide and Rodenticide Act as
well as other pesticides commonly regarded in the same category
and for the same purpose. See TIR 08-8 for more information.

The vendor must retain this certificate as part of his/her tax records. For further information regarding the requirements for retaining records, see Massachusetts Regulation, 830 CMR 62C.25.1.

This form may be used by a contractor when purchasing or leasing
tangible personal property from a vendor in connection with fulfilling
a contract with its customer if the property will be used for one of
the exempt uses described in Massachusetts General Laws (MGL)
chapter 64H, section 6(r) or (s), which include the following: use directly and exclusively in an industrial plant in the actual manufacture 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 manufacturing corporation or research and development corporation; in agricultural production; in commercial fishing.

Notice to Contractors

A contractor purchasing property exempt under MGL chapter 64H,
section 6(r) or (s), may sign and present this form to its vendor. The
contractor bears the burden of proof of demonstrating on audit that
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)
or (s), the contractor will be liable for the tax. An exempt use certificate furnished by the contractor’s customer to the contractor will
not relieve the contractor from liability. See DD 07-6, “Exemptions
under G.L. c. 64H, sec. 6(r) and sec. 6(s)” for further information.

This form is not to be used by an exempt organization (use Form
ST-5), or to claim the exemption for containers used to transport
food or drink off premises (use Form ST-12EC), or to claim the
small business energy exemption (use Form ST-13). For further
information on the proper form to use to claim an exemption for
the purchase of utilities and fuel see DD 92-3.

Notice to Purchasers

If a purchaser makes any use of the property other than an exempt
use, such property will be subject to the Massachusetts sales or
use tax, as of the time the property is first used.

For any exemption claimed in line 1 or 2, the purchaser must provide a description of the exempt property. For any exemption
claimed in line 6 for the purchase of gas, steam or electricity, the
purchaser must provide the service locations of the qualified property and utility account numbers. Attach an additional statement if
more space is needed.

A purchaser submitting a Multiple Points of Use Certificate by
checking line 9 agrees to report and remit the applicable sales or
use tax to the jurisdictions where the software will be used, using
any reasonable, but consistent and uniform, method of apportionment that is supported by the purchaser’s business records, as
they exist at the time a return is filed. See TIR 05-15.

If at any time a business that has presented this certificate ceases
to qualify for the exemption, it must revoke in writing the Form ST12 it has given to its vendor(s).

For further information regarding the acceptance or use of exempt
use certificates see Massachusetts Regulation, 830 CMR 64H.8.1.

Warning: Willful misuse of this certificate may result in criminal tax evasion penalties of up to one year in prison and
$10,000 ($50,000 for corporations) in fines.

If you have any questions about the acceptance or use of this certificate, please contact: Massachusetts Department of Revenue,
Customer Service Bureau, PO Box 7010, Boston, MA 02204;
(617) 887-MDOR, or toll-free in-state 1-800-392-6089.

printed on recycled paper