720-538-8660
1. PURCHASER INFORMATION
Shipping address *
Billing address *
Same as shipping address.
License or Exemption Information
Limit: 50 characters
2. WHOLESALE EXEMPTION
Mark the type of exemption, and describe your ordinary course of business.
Limit: 500 characters
3. ENTITY EXEMPTION
Enter a and b as required.
4. OTHER EXEMPTION
Describe the exemption claimed and how your purchase qualifies.
5. DOCUMENTATION
Provide a copy of your state sales tax exemption certificate, exemption card, and/or IRS determination letter. Documentation must clearly display the applicable exemption number and an authorized signature.
Accepted file types: PDF, DOC, DOCX, XLS, XLSX, JPG, JPEG, PNG, TXT
File size limit: 1000MB (1GB)
6. PURCHASER SIGNATURE
I declare that the purchases I make using this form qualify for exemption from Colorado sales and use taxes as entered above, and that I am the purchaser or have the authority to execute this form on behalf of the purchaser.*
I acknowledge that this electronic submission is intended to satisfy the information requirements of Colorado Department of Revenue Form DR 5002. I certify under penalty of perjury that the information provided is accurate and complete. I understand that an official copy of the completed form may be generated or provided upon request.*
By submitting this form, I certify under penalty of perjury that I am authorized to act on behalf of the entity claiming tax-exempt status and that all information and documentation provided is true, correct, and complete to the best of my knowledge. I understand that providing false or misleading information may result in denial or revocation of tax-exempt status and the imposition of penalties under applicable law.*
