Form PR-78SSTA "Streamlined Sales and Use Tax Agreement Certificate of Exemption (Kansas)" - Kansas

What Is Form PR-78SSTA?

This is a legal form that was released by the Kansas Department of Revenue - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2009;
  • The latest edition provided by the Kansas Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PR-78SSTA by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

ADVERTISEMENT
ADVERTISEMENT

Download Form PR-78SSTA "Streamlined Sales and Use Tax Agreement Certificate of Exemption (Kansas)" - Kansas

Download PDF

Fill PDF online

Rate (4.4 / 5) 68 votes
Certificate of Exemption (Kansas)
Streamlined Sales and Use Tax Agreement
This is a multi-state form. Not all states allow all exemptions listed on this form. Purchasers are responsible for knowing if they qualify
to claim exemption from tax in the state that would otherwise be due tax on this sale. The seller may be required to provide this
exemption certificate (or the data elements required on the form) to a state that would otherwise be due tax on this sale.
The purchaser will be held liable for any tax and interest, and possibly civil and criminal penalties imposed by the member state, if the
purchaser is not eligible to claim this exemption. A seller may not accept a certificate of exemption for an entity-based exemption on a
sale made at a location operated by the seller within the designate state if the state does not allow such an entity-based exemption.
1.
Check if you are attaching the Multi-state Supplemental form.

If not, enter the two-letter postal abbreviation for the state under whose laws you are claiming exemption.
2.
Check if this certificate is for a single purchase and enter the related invoice/purchase order #
.
3.
Please print
Name of purchaser
Business Address
City
State
ZIP
Purchaser’s Tax ID Number
State of Issue
Country of Issue
If no Tax ID Number
FEIN
Driver’s License Number/State Issued ID Number
Foreign diplomat Number
Enter one of the following
State of Issue:
Number
Name of seller from whom you are purchasing, leasing or renting
State
Seller’s Address
City
ZIP
4.
Type of business. Circle the number that describes your business
01
Accommodation and Food Services
11
Transportation and Warehousing
02
Agricultural, Forestry, Fishing, Hunting
12
Utilities
03
Construction
13
Wholesale Trade
04
Finance and Insurance
14
Business Services
05
Information, Publishing and Communications
15
Professional Services
06
Manufacturing
16
Education and Health-Care Services
07
Mining
17
Nonprofit Organization
08
Real Estate
18
Government
09
Rental and Leasing
19
Not a Business
10
Retail Trade
20
Other
(explain)
5.
Reason for exemption. Circle the letter that identifies the reason for the exemption.
A
Federal Government
(department)
G
Resale #
B
State or Local Government
(name)
H
Agricultural Production #
I
Industrial Production/Manufacturing #
D
Foreign Diplomat #
J
Direct Pay Permit #
E
Charitable Organization #
K
Direct Mail #
F
Religious or Educational Organization #
L
Other
(explain)
6.
Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
Signature of Authorized Purchaser
Print Name Here
Title
Date
PR-78SSTA
(Rev. 10/09)
Certificate of Exemption (Kansas)
Streamlined Sales and Use Tax Agreement
This is a multi-state form. Not all states allow all exemptions listed on this form. Purchasers are responsible for knowing if they qualify
to claim exemption from tax in the state that would otherwise be due tax on this sale. The seller may be required to provide this
exemption certificate (or the data elements required on the form) to a state that would otherwise be due tax on this sale.
The purchaser will be held liable for any tax and interest, and possibly civil and criminal penalties imposed by the member state, if the
purchaser is not eligible to claim this exemption. A seller may not accept a certificate of exemption for an entity-based exemption on a
sale made at a location operated by the seller within the designate state if the state does not allow such an entity-based exemption.
1.
Check if you are attaching the Multi-state Supplemental form.

If not, enter the two-letter postal abbreviation for the state under whose laws you are claiming exemption.
2.
Check if this certificate is for a single purchase and enter the related invoice/purchase order #
.
3.
Please print
Name of purchaser
Business Address
City
State
ZIP
Purchaser’s Tax ID Number
State of Issue
Country of Issue
If no Tax ID Number
FEIN
Driver’s License Number/State Issued ID Number
Foreign diplomat Number
Enter one of the following
State of Issue:
Number
Name of seller from whom you are purchasing, leasing or renting
State
Seller’s Address
City
ZIP
4.
Type of business. Circle the number that describes your business
01
Accommodation and Food Services
11
Transportation and Warehousing
02
Agricultural, Forestry, Fishing, Hunting
12
Utilities
03
Construction
13
Wholesale Trade
04
Finance and Insurance
14
Business Services
05
Information, Publishing and Communications
15
Professional Services
06
Manufacturing
16
Education and Health-Care Services
07
Mining
17
Nonprofit Organization
08
Real Estate
18
Government
09
Rental and Leasing
19
Not a Business
10
Retail Trade
20
Other
(explain)
5.
Reason for exemption. Circle the letter that identifies the reason for the exemption.
A
Federal Government
(department)
G
Resale #
B
State or Local Government
(name)
H
Agricultural Production #
I
Industrial Production/Manufacturing #
D
Foreign Diplomat #
J
Direct Pay Permit #
E
Charitable Organization #
K
Direct Mail #
F
Religious or Educational Organization #
L
Other
(explain)
6.
Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
Signature of Authorized Purchaser
Print Name Here
Title
Date
PR-78SSTA
(Rev. 10/09)
Certificate of Exemption
Streamlined Sales and Use Tax Agreement
Multi-state Supplemental
Name of Purchaser
STATE
Reason for Exemption
Identification Number (If Required)
AR
IA
IN
KS
KY
MI
MN
NC
ND
NE
NJ
NV
OH
OK
RI
SD
TN*
UT
VT
WA
WV
WY
*SSUTA Direct Mail provisions are not in effect for Tennessee.
The following nonmember states will accept this certificate for exemption claims that are valid in their respective state. SSUTA Direct Mail
provisions do not apply in these states.
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
Page of 2