Form ST-28B "Statement for Sales Tax Exemption on Electricity, Gas, or Water Furnished Through One Meter" - Kansas

What Is Form ST-28B?

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 April 1, 2021;
  • 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 ST-28B by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

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Download Form ST-28B "Statement for Sales Tax Exemption on Electricity, Gas, or Water Furnished Through One Meter" - Kansas

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KANSAS DEPARTMENT OF REVENUE
465818
STATEMENT FOR SALES TAX EXEMPTION ON ELECTRICITY, GAS, OR
WATER FURNISHED THROUGH ONE METER
Please type or print this form and send a completed copy WITH worksheets to your utility company. Complete a form for each meter on
which you are applying for an exemption.
. _______________________________________________________________
__________________________________________________________
1
Address of meter location
Utility account number
2. In accordance with the Kansas Retailers’ Sales Tax Act, the undersigned purchaser states that the (circle one: electricity, gas, water)
__________________________________________________________________________
sold and furnished by (name of utility company)
through
_______________________________
meter number
at the above location issued for the following purposes based on annual consumption.
______________________________________________________________
3.
uses electricity, gas or water for the following purpose (check one):
PURCHASER (Name of individual, company, or organization)
Unless otherwise indicated, the uses below are exempt from state and local sales tax.
o
o
Agricultural use.
Severing of oil.
(Electricity & gas subject to local sales tax.)
o
o
Ingredient or component part.
Certain nonprofit corporations exempt from real estate
property tax – i.e., adult care homes (nursing homes);
o
Irrigation of crops.
private children’s homes (nursing home foster care, etc.);
o
Movement in interstate commerce by railroad or public utility.
housing for low and limited income elderly and disabled
o
*Noncommercial educational radio or TV station.
persons (includes HUD housing projects); housing for the
o
Noncommercial residential use.
(Electricity & gas subject to
elderly; and group housing for people with an intellectual
local sales tax.)
disability and other disabled persons.
Attach a copy of the
o
*Nonprofit hospital.
“order” from the Board of Tax Appeals.
o
o
*Nonprofit museum or historical society.
Consumed in the production, manufacturing, processing,
mining, drilling, refining, or compounding of tangible
o
*Nonprofit zoo.
personal property, or treatment of by-products or wastes of
o
*Over-the-air free access radio or TV station. Only the
any above processes.
electricity used to produce the broadcast signal is exempt. All
o
Domestic violence shelters.
other utility use is taxable.
o
o
Providing taxable services.
*Educational institutions and nonprofit trusts, nonprofit
endowment associations and foundations operated for the
o
*Religious organization exempt from federal taxation under
sole benefit of an education institution.
section 501(c)(3) of the federal Internal Revenue Code.
o
*Government entity.
o
*Other exempt entity
*
Enter Sales Tax Exemption Identification Number
_____________________________________
Employer ID Number (EIN)
__________________________
_____________________________________________________________________________________________________________
4. Type of business
5. Describe the taxable service; movement in interstate commerce; agricultural use; or property produced, manufactured, etc.
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
NOTE: Sales of water to residential premises for noncommercial use or for agricultural use are NOT subject to local (city/county) sales
tax. However, all electricity and gas used to light, heat, cool, clean or maintain equipment, buildings or business facilities (offices, plants,
shops, warehouses) are FULLY TAXABLE. This includes, but is not limited to, electricity and gas for air conditioners, all lighting (including
production area), exhaust fans, freezers, heaters, refrigerators, other appliances and machines.
6. EXEMPT PERCENT
____________
% (See instructions.)
The undersigned purchaser agrees and certifies that: a) this statement is true, correct, and complete; b) the worksheets used to determine
the “Exempt Percent” will be kept by the undersigned and copies of the worksheets and this completed form will be provided
to the utility company); and, c) in the event there is a change in the “Exempt Percent”, a revised statement will be filed immediately with
the utility company. If the electricity, gas, or water exempted from taxation is determined to be taxable at a rate other than stated above,
the undersigned purchaser agrees to reimburse the utility company or the Kansas Department of Revenue for any amounts assessed as
retailers’ sales or compensating tax, penalties, and/or interest.
___________________________________________________________________
_____________________________________
Purchaser:
Phone No.
Individual, company, or organization name
__________________________________________________________________________________________________________________________
Address:
Street, RR, or P.O. Box, City, State, Zip + 4
Email Address
____________________________________________________________________________________________________
Date: ______________________
Printed Name
*Authorized Signature
ONLY the Owner, Partner, Company Officer or authorized Power of Attorney may sign this form.
o
o
No
Yes
The individual signing this form authorizes KDOR to discuss this statement for sales tax utility exemption with any employee of the
company and not only the individual signing this exemption request. A
DO-10 (POA)
is required documentation if the request is prepared/filed by a 3rd party.
ST-28B (Rev.
4-21)
KANSAS DEPARTMENT OF REVENUE
465818
STATEMENT FOR SALES TAX EXEMPTION ON ELECTRICITY, GAS, OR
WATER FURNISHED THROUGH ONE METER
Please type or print this form and send a completed copy WITH worksheets to your utility company. Complete a form for each meter on
which you are applying for an exemption.
. _______________________________________________________________
__________________________________________________________
1
Address of meter location
Utility account number
2. In accordance with the Kansas Retailers’ Sales Tax Act, the undersigned purchaser states that the (circle one: electricity, gas, water)
__________________________________________________________________________
sold and furnished by (name of utility company)
through
_______________________________
meter number
at the above location issued for the following purposes based on annual consumption.
______________________________________________________________
3.
uses electricity, gas or water for the following purpose (check one):
PURCHASER (Name of individual, company, or organization)
Unless otherwise indicated, the uses below are exempt from state and local sales tax.
o
o
Agricultural use.
Severing of oil.
(Electricity & gas subject to local sales tax.)
o
o
Ingredient or component part.
Certain nonprofit corporations exempt from real estate
property tax – i.e., adult care homes (nursing homes);
o
Irrigation of crops.
private children’s homes (nursing home foster care, etc.);
o
Movement in interstate commerce by railroad or public utility.
housing for low and limited income elderly and disabled
o
*Noncommercial educational radio or TV station.
persons (includes HUD housing projects); housing for the
o
Noncommercial residential use.
(Electricity & gas subject to
elderly; and group housing for people with an intellectual
local sales tax.)
disability and other disabled persons.
Attach a copy of the
o
*Nonprofit hospital.
“order” from the Board of Tax Appeals.
o
o
*Nonprofit museum or historical society.
Consumed in the production, manufacturing, processing,
mining, drilling, refining, or compounding of tangible
o
*Nonprofit zoo.
personal property, or treatment of by-products or wastes of
o
*Over-the-air free access radio or TV station. Only the
any above processes.
electricity used to produce the broadcast signal is exempt. All
o
Domestic violence shelters.
other utility use is taxable.
o
o
Providing taxable services.
*Educational institutions and nonprofit trusts, nonprofit
endowment associations and foundations operated for the
o
*Religious organization exempt from federal taxation under
sole benefit of an education institution.
section 501(c)(3) of the federal Internal Revenue Code.
o
*Government entity.
o
*Other exempt entity
*
Enter Sales Tax Exemption Identification Number
_____________________________________
Employer ID Number (EIN)
__________________________
_____________________________________________________________________________________________________________
4. Type of business
5. Describe the taxable service; movement in interstate commerce; agricultural use; or property produced, manufactured, etc.
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
NOTE: Sales of water to residential premises for noncommercial use or for agricultural use are NOT subject to local (city/county) sales
tax. However, all electricity and gas used to light, heat, cool, clean or maintain equipment, buildings or business facilities (offices, plants,
shops, warehouses) are FULLY TAXABLE. This includes, but is not limited to, electricity and gas for air conditioners, all lighting (including
production area), exhaust fans, freezers, heaters, refrigerators, other appliances and machines.
6. EXEMPT PERCENT
____________
% (See instructions.)
The undersigned purchaser agrees and certifies that: a) this statement is true, correct, and complete; b) the worksheets used to determine
the “Exempt Percent” will be kept by the undersigned and copies of the worksheets and this completed form will be provided
to the utility company); and, c) in the event there is a change in the “Exempt Percent”, a revised statement will be filed immediately with
the utility company. If the electricity, gas, or water exempted from taxation is determined to be taxable at a rate other than stated above,
the undersigned purchaser agrees to reimburse the utility company or the Kansas Department of Revenue for any amounts assessed as
retailers’ sales or compensating tax, penalties, and/or interest.
___________________________________________________________________
_____________________________________
Purchaser:
Phone No.
Individual, company, or organization name
__________________________________________________________________________________________________________________________
Address:
Street, RR, or P.O. Box, City, State, Zip + 4
Email Address
____________________________________________________________________________________________________
Date: ______________________
Printed Name
*Authorized Signature
ONLY the Owner, Partner, Company Officer or authorized Power of Attorney may sign this form.
o
o
No
Yes
The individual signing this form authorizes KDOR to discuss this statement for sales tax utility exemption with any employee of the
company and not only the individual signing this exemption request. A
DO-10 (POA)
is required documentation if the request is prepared/filed by a 3rd party.
ST-28B (Rev.
4-21)
INSTRUCTIONS FOR COMPLETING FORM ST-28B
When gas, water, or electricity is furnished through one
in the actual process at the location during the production activity;
meter for both taxable and exempt purposes, the purchaser is
3) immediately consumed or dissipated in the process; and,
responsible for determining the percentage of use exempt from
4) used in the production, manufacturing, processing, mining,
sales tax. The sample worksheet provided below will help you to
drilling, refining, or compounding of tangible personal property or
determine the percent of electricity, gas, or water that qualifies
the treatment of by-products or wastes of any above processes.
for exemption. The worksheet you provide should list all taxable
The following uses of electricity, gas, or water are not exempt from
and exempt equipment. If you have questions about this form,
sales tax: shipping, repairing, servicing, maintaining, cleaning the
contact Audit Services/Sales Tax Refunds, Kansas Department
equipment and the physical plant, and storing.
of Revenue, 109 SW 9th St., PO Box 3506, Topeka, KS,
INGREDIENT OR COMPONENT PART
: An example of electricity,
66601-3506, email
KDOR_Audit.Funds@ks.gov
or call 785-296-2549.
gas, or water which becomes an ingredient or component part and
*Authorized Signature: The Owner, Partner, Company Officer
qualifies for exemption is “water” that is part of the ingredient in a
signing this form authorizes KDOR to discuss this statement for
beverage which is bottled and sold to a retailer for resale.
sales tax utility exemption with any employee of the company and
RESIDENTIAL
: If the electricity, gas, or water you consume is
not only the individual signing this exemption request. A
DO-10
for residential use only, you do not need to file this form. The utility
(POA)
is still required documentation if the request is prepared/
company automatically exempts you from paying state sales tax
filed by a 3rd party.
(city and county sales tax still applies). However, if the electricity,
AGRICULTURAL
: Electricity and gas for agricultural use is
gas, or water you consume is partly for residential purposes and
exempt from the state sales tax but not exempt from the local
partly for commercial use, you must determine the percent of
taxes. Agricultural use does not include commercial operations
usage that is residential and file copies of your worksheets and
such as processing food or dairy products, off-farm grain storage
this completed form with your utility company and the Department
and marketing, lumbering, or use by a stockyard, slaughter house,
of Revenue. Utilities consumed in commercial common areas
floral shop, or turf farm.
such as an office, lounge, hallway, laundry facility, storage area,
swimming pool, etc., do not qualify for exemption.
CERTAIN NONPROFIT CORPORATIONS
: Sales of electricity,
HOW MUCH OF MY UTILITY USE QUALIFIES FOR
gas, or water to properties which are exempt from property taxation
EXEMPTION?
under K.S.A. 79-201b Second through Sixth are exempt from
You will probably need several sheets of paper
state and local sales tax. Once the property is determined to be
as worksheets. If your facility is serviced by more than one meter,
exempt, copies of the “order” from the Board of Tax Appeals and
you need to complete a separate chart to determine the percent of
this completed exemption certificate (ST-28B) must be provided to
usage for each meter. If the facility is heated and air-conditioned
the utility company and the Kansas Department of Revenue.
by a central unit, you may use the square footage method to
arrive at the residential percent of consumption for heating and
CONSUMABLES
: The portion of electricity, gas, or water you
cooling. You may need the assistance of a plumber or electrician
use that meets the following requirements is exempt from state
to complete the formulas. Refer to the following example and
and local taxes: 1) essential or necessary to the process; 2) used
steps to determine your exempt percent.
COLUMN 1
COLUMN 2
COLUMN 3
COLUMN 4
COLUMN 5
COLUMN 6
E X A M P L E
Estimated
Number of Days
Usage Per Year
Rating of
Hours of
the Device is
stated in kWh,
Type of Device
Device
Use Per Day
Load Factor
Used Per Year
BTU, or Gallons
20 - light bulbs
T
40 watts
10
1.00
324
2,592 kWh
1 - production machinery
E
500 watts
10
.50
255
637.5 kW
1. At the top of each page, place the headers as noted in the
2. Indicate beside each type of device an “E” for exempt or a
example and complete the following information per column:
“T” for taxable.
COLUMN 1—List each device that is pulling the utility.
3. Multiply the quantity in column 1 by column 2 by column 3 by
COLUMN 2—Rating of each device.
column 4 by column 5 to arrive at the sum for column 6.
COLUMN 3—Estimate the number of hours of use per day
(i.e., on average, twenty 40 watt light bulbs are on ten
4. Add the usage per year (column 6) for all of the devices you
hours per day, therefore, enter “10”).
have indicated as “exempt” then add all of the usage per
COLUMN 4—Determine and enter load factor (i.e., when a
year (column 6) for all the devices that you have indicated
light bulb is on it pulls the full rate of 100% power but a
as being “taxable.” Adding the exempt and taxable usage
burner on the stove on “low” may only pull 30% load factor).
should equal the total consumption per year as shown on
COLUMN 5—Number of days the device is used per year.
your utility bills for the last 12 months.
COLUMN 6—Determine usage per year stated in kilowatt-
hours (kWh), BTU, or gallons.
5. Divide the total number of exempt kWh by the total number
1000 watts = 1 kWh
of kWh consumed in the last 12 months. This is the percent
Horsepower = .746 X H.P. = watts
of usage that is exempt from tax. Enter this amount on line 5
Ten 100-watt bulbs burning 1 hour will use 1 kWh
on the front of this form (ST-28B).
1,000,000 BTU in 1 MCF
The instructions provided are intended to help consumers of electricity, gas, or water complete this form.
In case of discrepancies, the applicable law prevails.
ATTN: Hotels, Motels and Nursing Homes: Please include the occupancy rate
for the last 12 months of business with your study.
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