Letter of Approval and PEC (#106265)Department of Revenue
RE: Exemption Certificate #«Certificate Number»
«Type of project»
Your request for a sales and compensating tax exemption certificate number for the above
captioned project has been approved.
The number assigned to you for the above captioned project is for the contractor’s,
subcontractor’s, or repairman’s use in purchasing tangible personal property and labor services
tax exempt as set out in K.S.A. 79-3606(c), (d), (e), (xx), (aaa), (ccc), (iii), (qqq), (sss), (ttt),
(uuu), (xxx) and (yyy). The sales or compensating tax exemption number must be available to
the supplier at the time the invoice is rendered or the exemption for sales or compensating tax
cannot be claimed.
You will find enclosed an exemption certificate (PR-74) which you will furnish the contractor,
subcontractor, or repairman. The contractor, subcontractor or repairman may reproduce as many
copies of this form as they need for their suppliers. You will also want to furnish a copy of the
completion certificate to the contractor(s). Upon completion of the project, a project completion
certificate (PR-77) must be provided to you by the contractor(s). You will need to retain the
completion certificate in your office and you will want to record the completion date on-line.
You can apply for future project exemption certificates, download completion certificates and/or
record the completion date on-line at www.kdor.ks.gov/apps/kcsc/. If you do not have access
to the internet, please contact the department at (785) 296-8460 for assistance.
Sincerely,
«Reviewers Name»
Division of Taxation Phone: 785-296-3081
109 SW 9th Street Fax: 785-296-7928
Topeka, KS, 66601-3506 www.ksrevenue.gov
Mark A. Burghart, Secretary Laura Kelly, Governor
09/29/2022
Adina Mayhew
Debbie Pack
City of Salina
300 West Ash
PO Box 736
Salina , KS 67402-0736
0000106265
Taxable Industrial Revenue Bonds
Division of Taxation
KANSAS DEPARTMENT OF REVENUE
DIVISION OF TAXATION
PROJECT EXEMPTION CERTIFICATE
PERMIT TO PURCHASE TANGIBLE PROPERTY OR SERVICES WITHOUT PAYMENT OF SALES
TAX, LOCAL SALES TAX, OR COMPENSATING TAX
The undersigned purchaser certifies that the sale of tangible personal property by
of ,
(name of vendor) (City, State)
is exempt from the Kansas Sales and Compensating (Use) Tax pursuant to K.S.A. 79-3606(c), (d), (e), (xx),
(aaa), (ccc), (iii), (qqq), (sss), (ttt), (uuu), (xxx) and (yyy) or the Retailers’ Sales Tax Act.
Pursuant to the above section, the exemption certificate number below must appear on the invoice
covering such sale.
Date Purchaser
(Contractor/Subcontractor)
Address
City, State
Authorized Signature
NOT VALID ON PURCHASES MADE PRIOR TO: «Date Submitted»
NOT VALID ON PURCHASES MADE AFTER: «Estimated Completion date»
Exemption Certificate No.: «Certificate Number»
«Name of your organization»
«Project Number»
Name of tax exempt entity, pursuant to K.S.A. 79-3606(c), (d), (e), (xx), (aaa), (ccc), (iii), (qqq), (sss), (ttt), (uuu), (xxx) and (yyy), as amended, with whom the contract has been signed:
Project number (if used):
Location of project (city or county): «Physical address for project»
Description of project: «Type of project»
INSTRUCTIONS
EXEMPT ORGANIZATION-A copy of this certificate (as issued by the Department of Revenue) should
be furnished to each contractor or subcontractor who will be purchasing tangible personal property for use
on the project.
CONTRACTOR/SUBCONTRACTOR-A completed copy of this exemption certificate must be furnished
to each retailer from which the contractor/subcontractor is making purchases of tangible personal property
for use on the project.
RETAILER-A completed copy of this exemption certificate must be retained by the retailer from each
contractor/subcontractor making purchases of tangible personal property for use on the project.
PR-74
(Rev: 09/16)
City of Salina
0000106265
Taxable Industrial Revenue Bonds
09/27/2022
05/31/2023
Dominion
1840 WALL STREET SALINA, KS;