Norbys Iowa Sales/Use/Excise Tax Exemption Certificate

Norbys Iowa Sales/Use/Excise Tax Exemption Certificate
Thank you for taking the time to complete the Iowa Sales/Use/Excise Tax Exemption Certificate form online. After you eSign the document, you may notice that the form contains 5 unique entities. This document outlines the organization of Norby locations and enables you to sign one form to establish tax exemption at all our locations.

Documents signed via this webpage will be processed and added to the system within 10 business days.

If you choose to submit a paper copy of this form, please allow 3 weeks for the form to be processed and added to the system. We will notify you via email when your exemption status is loaded into our cash registers.

Using this webpage to complete and sign the form will streamline the process. Approximately 45 days before the expiration of your current certificate, you will receive an email from us containing a link to complete this form again.

If you have any questions on this process, please get in touch with us at taxexempt@norbysfarmfleet.com
Type of Certificate:
Is this a new certificate, or is it a renewal for an existing certificate?*
Purchaser legal name*
Doing business as
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone*
Email*
example@example.com
Purchaser doing business as:*

RetailerRetailer car dealerGovernmental agency (including public schools)WholesalerFarmerLessorManufacturerNonprofit hospitalPrivate nonprofit educational institutionQualifying residential care facilityNonprofit museumCommercial enterpriseNonprofit food bankOther - If checked, explain general nature of business.
Retailer - Sales/use/excise tax permit number (if required):
Retailer car dealer - Enter your DOT number:*
Purchaser is claiming exemption for the following reason:*

ResaleLeasingProcessingQualifying farm machinery/equipmentQualifying farm replacement partsQualifying manufacturing machinery/equipmentResearch and development equipmentPollution control equipmentRecycling equipmentQualifying computer or computer peripheralQualifying replacement parts/supplies (manufacturing, research & development, pollution control, recycling, computer)Qualifying computer software, specified digital products and digital servicesGrain bins and replacement partsDirect payOther
Permit number required:*
Do you have a John Deere Financial account?*

YesNo
Signature*
Title
Your Email*
Date*
Signature Date

MonthDayYear
Date
Renewal Reminder

MonthDayYear
Date
Signer Data
Should be Empty:

Norbys Iowa Sales/Use/Excise Tax Exemption Certificate

Type of Certificate: