Otr 553 Form – Fill Out and Use This PDF

This is a FILL-IN format. Please do not handwrite any data on this form other than your signature.

GOVERNMENT OF THE DISTRICT OF COLUMBIA

OFFICE OF TAX AND REVENUE

OTR-553 CONTRACTOR’S EXEMPT PURCHASE CERTIFICATE

DISTRICT OF COLUMBIA SALES AND USE TAX

TO:			ISSUED BY:
VENDOR			PURCHASER (CONTRACTOR OR SUBCONTRACTOR)
VENDORS’ STREET ADDRESS			TRADE NAME (IF ANY)
CITY	STATE	ZIP CODE	PURCHASER’S STREET ADDRESS
SELLER MUST KEEP THIS CERTIFICATE			CITY	STATE	ZIP CODE
TO SUBSTANTIATE EXEMPT STATUS
FEIN			DC SALES AND USE TAX ACCOUNT ID NUMBER

			TYPES OF EXEMPTION
		FEDERAL GOVERNMENT		FEDERAL CONTRACT #
		DC GOVERNMENT		DC CONTRACT #
		SEMIPUBLIC INSTITUTION		EXEMPTION # OF SEMIPUBLIC INSTITUTION

PROJECT IDENTIFICATION

NAME OF U.S. OR DC AGENCY OR INSTRUMENTALITY, SEMIPUBLIC INSTITUTION OR FOREIGN GOVERNMENT

ORGANIZATION STREET ADDRESS

CITY

STATE

ZIP CODE

NAME AND TYPE OF PROJECT

PROJECT LOCATION

I/we certify that as issuer of this certificate I/we have entered into a contract for the construction of real property for the exempt organization indicated and that all materials purchased are for physical incorporation in this project are exempt from DC Sales and Use Tax.

AUTHORIZED SIGNATURE

TITLE

DATE

This certificate does not extend to equipment rentals or any sales of materials whose nature precludes physical incorporation as a permanent part of the real property. To be eligible to use this certificate, you must file DC Form FR-500, Combined Business Tax Registration Application with the Office of Tax and Revenue, 1101 4th Street, SW Washington DC 20024 (202-727-4829).

OTR-553 REV 05-16