Kan. Admin. Regs. § 92-19-25b
(c) Exemption certificates shall substantially comply with the following format:
| KANSAS EXEMPTION CERTIFICATE |
| I certify that the sale of tangible personal property or service by: |
| _______________________________________ |
| (Vendor's name) |
| _______________________________________ |
| of __________________, Kansas, to me or to the entity that I represent is exempt from the tax levied by the Kansas retailers' sales and compensating tax act for the following reasons: |
| _______________________________________ |
| _______________________________________ |
| As purchaser, I understand and agree that if the property or service is used in any manner that is not exempt from tax under the act, the entity that I represent becomes liable for the tax, as do I personally |
| Date: _____________ |
| Purchaser: |
| _______________________________________ |
| (Signature and SSN or FEIN) |
| Name of the entity: ______________________ |
| _______________________________________ |
| Address: _______________________________ |
| _______________________________________ |
| _______________________________________ |
(e) A resale exemption certificate may be issued by a registered retailer to claim exemption from tax for purchases of property or services that the retailer intends to resell on the normal course of business or that the retailer is unable to determine will be resold or used by the retailer for some other purpose. Resale exemption certificates shall substantially comply with the following format:
| KANSAS RESALE EXEMPTION CERTIFICATE |
| _______________________________________ |
| (Name of purchaser) |
| _______________________________________ |
| _______________________________________ |
| (Address of purchaser) |
| _______________________________________ |
| _______________________________________ |
| I hereby certify that: I hold valid retailer registration No.________issued pursuant to the Kansas sales and compensating tax law: |
| I am engaged in the business of selling: |
| _______________________________________ |
| ______________________________________; |
| The tangible personal property described herein which I shall purchase from: |
| _______________________________________ |
| (Vendor's name) |
| _______________________________________ |
| will be resold by me in the form of tangible personal property; |
| I further agree that, if any of the property is used for any purpose other than retention, demonstration, or display while holding it for resale in the regular course of business, I will report and pay Kansas state and local sales tax to the Kansas Department of Revenue, based on the amount that I paid for the property. |
| Description of property to be purchased: |
| _______________________________________ |
| _______________________________________ |
| Date: _____________ |
| _______________________________________ |
| (Signature of purchaser or authorized agent and SSN or FEIN) |
(Authorized by K.S.A. 79-3606, 79-3618; implementing K.S.A. 79-3602, 79-3603, 79-3609, 79-3610, 79-3611; effective June 26, 1998.)