Wisconsin Sales and Use Tax Exemption Certificate
Do not send this certificate to the Department of Revenue
Form S-211
Purchaser: Complete this certificate and give it to the seller.
Seller: If this certificate is not fully completed, you must charge sales tax. Keep this certificate as part of your records.
Purchaser Information
Business Name
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Purchaser's Tax ID Number
*
State of Issue
*
Reason for Exemption
Resale (Enter purchaser's seller's permit or use tax certificate number)
Enter purchaser's seller's permit or use tax certificate number
*
I declare that the information provided is complete and accurate to the best of my knowledge, and that the product(s) purchased will be used in the exempt manner indicated. If a product is not used in an exempt manner, I will remit use tax on the purchase price at the time of first taxable use. I understand that failure to remit the use tax may result in a future liability, including tax, interest, and penalty.
CAUTION: Using this certificate to avoid paying sales tax may result in a fine of $250 for each transaction for which the certificate is used
Signature of Purchaser
*
Print or Type Name
*
Title
*
Date
*
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Month
-
Day
Year
Date
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