Wisconsin S211 Form Please fill out the form below and we will submit your S211 form: Check One: *Single PurchaseContinuousEmail AddressPurchaser InformationIndividual Name *Farm Name *Phone Number *Mobile NumberBusiness Name *Type of Business *Select Business TypeAccommodation and food servicesAgricultural, forestry, fishing, huntingBusiness servicesConstructionEducationFinance and insuranceGovernmentHealthcare servicesIndividual consumerManufacturingMiningNonprofit organizationProfessional servicesReal estateRental or leaseRetailTransportation and warehousingUtilitiesWholesaleOtherBusiness Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Purchaser's Tax ID NumberState of IssueFarm Address (if different)CityState/ProvinceZIP / Postal CodeMain ContactPlastic ContactBilling ContactHow did you hear about us?FEIN *Driver's License Number/State Issued ID Number *State of IssueREASON FOR EXEMPTIONResaleEnter purchaser’s seller’s permit or use tax certificate numberManufacturing and BiotechnologyTangible personal property (TPP) or item under s.77.52(1)(b) that is used exclusively and directly by a manufacturer in manufacturing an article of TPP or items or property under s.77.52(1)(b) or (c) that is destined for sale and that becomes an ingredient or component part of the article of TPP or items or property under s.77.52(1)(b) or (c) destined for sale or is consumed or destroyed or loses its identity in manufacturing the article of TPP or items or property under s.77.52(1)(b) or (c) destined for sale.Machines and specific processing equipment and repair parts or replacements thereof, exclusively and directly used by a manufacturer in manufacturing tangible personal property or items or property under s.77.52(1)(b) or (c) and safety attachments for those machines and equipment.The repair, service, alteration, fitting, cleaning, painting, coating, towing, inspection, and maintenance of machines and specific processing equipment, that the above purchaser would be authorized to purchase without sales or use tax, at the time the service is performed. Tools used to repair exempt machines are not exempt.Property used exclusively and directly in qualified research, by persons engaged in manufacturing at a building assessed under s. 70.995, by persons engaged primarily in biotechnology in Wisconsin, or a combined group member conducting qualified research for another combined group member that meets these requirements.s.77.52(1)(b) or (c)Fuel and electricity consumed in manufacturing tangible personal property or items or property under s.77.52(1)(b) or (c) in this state.% of Fuel Exempt% of Electricity ExemptPortion of the amount of fuel converted to steam for purposes of resale.% of Fuel ExemptFarming(To qualify for this exemption, the purchaser must use item(s) exclusively and directly in the business of farming, including dairy farming, agriculture, horticulture, floriculture, silviculture, beekeeping or custom farming services.)Tractors (except lawn and garden tractors), all-terrain vehicles (ATV) and farm machines, including accessories, attachments, and parts, lubricants, nonpowered equipment, and other tangible personal property or items or property under s.77.52(1)(b) or (c) that are used exclusively and directly, or are consumed or lose their identities in the business of farming. This includes services to the property and items above.Feed, seeds for planting, plants, fertilizer, soil conditioners, sprays, pesticides, and fungicidesBreeding and other livestock, poultry, farm work stock, bees, beehives and bee combs.Containers for fruits, vegetables, bee products, grain, hay, and silage (including containers used to transfer merchandise to customers), and plastic bags, sleeves, and sheeting used to store or cover hay and silage. Baling twine and baling wire.Animal waste containers or component parts thereof (may only mark certificate as “Single Purchase”).Animal bedding, drugs for farm livestock or bees, and milk house supplies.Governmental Units and Other Exempt EntitiesThe United States and its unincorporated agencies and instrumentalities.Any federally recognized American Indian tribe or band in this state.Wisconsin state and local governmental units, including the State of Wisconsin or any agency thereof, Wisconsin counties, cities, villages, or towns, and Wisconsin public schools, school districts, universities, or technical college districts.Organizations meeting the requirements of section 501(c)(3) of the Internal Revenue Code. Wisconsin organizations must enter a CES number aboveEnter CES No. if applicableOtherContainers and other packaging, packing, and shipping materials, used to transfer merchandise to customers of the purchaser.Trailers and accessories, attachments, parts, supplies, materials, and service for motor trucks, tractors, and trailers which are used exclusively in common or contract carriage under LC, IC, or MCLC, IC, or MC No. (if applicable)Machines and specific processing equipment used exclusively and directly in a fertilizer blending, feed milling, or grain drying operation, including repair parts, replacements, and safety attachments.Building materials acquired solely for and used solely in the construction or repair of holding structures used for weighing and dropping feed or fertilizer ingredients into a mixer or for storage of such grain, if such structures are used in a fertilizer blending, feed milling, or grain drying operation.Tangible personal property purchased by a person who is licensed to operate a commercial radio or television station in Wisconsin, if the property is used exclusively and directly in the origination or integration of various sources of program material for commercial radio or television transmissions that are generally available to the public free of charge without a subscription or service agreement.Tangible personal property, property, items and goods under s.77.52(1)(b), (c), and (d), or services purchased by a Native American; where buyer will take possession of such property, items, goods, or services.Enrollment #Reservation NameFuel and electricity consumed in the origination or integration of various sources of program material for commercial radio or television transmissions that are generally available to the public free of charge without a subscription or service agreement.% of Fuel Exempt% of Electricity ExemptTangible personal property and items and property under s.77.52(1)(b) and (c) becoming a component of an industrial or municipal waste treatment facility, including replacement parts, chemicals, and supplies used or consumed in operating the facility. Caution: Do not check the “continuous” box.Portion of the amount of electricity or natural gas used or consumed in an industrial waste treatment facility.Percent of electricity or natural gas exemptElectricity, natural gas, fuel oil, propane, coal, steam, corn, and wood (including wood pellets which are 100% wood) used for fuel for residential or farm use.ResidentialResidential% of Electricity Exempt% of Natural Gas Exempt% of Fuel ExemptFarmFarm% of Electricity Exempt% of Natural Gas Exempt% of Fuel ExemptAddress DeliveredApartment, suite, etcCityState/ProvinceZIP / Postal CodePrinted advertising material solely for out-of-state use.Out of State AdvertisingPercent of printed advertising material solely for out-of-state use.Percent:Catalogs, and the envelopes in which the catalogs are mailed, that are designed to advertise and promote the sale of merchandise or to advertise the services of individual business firms.Computers and servers used primarily to store copies of the product that are sent to a digital printer, a plate-making machine, or a printing press or are used primarily in prepress or postpress activities, by persons whose NAICS code is 323111, 323117, or 323120.Purchases from out-of-state sellers of tangible personal property that are temporarily stored, remain idle, and not used in this state and that are then delivered and used solely outside this state, by persons whose NAICS code is 323111, 323117, or 323120.OtherOther purchases exempted by law.Other purchases exempted by law. (State items and exemption).I declare that the information provided is complete and accurate to the best of my knowledge, and that the product(s) purchased will be used in the exempt manner indicated. If a product is not used in an exempt manner, I will remit use tax on the purchase price at the time of first taxable use. I understand that failure to remit the use tax may result in a future liability, including tax, interest, and penalty. CAUTION: Using this certificate to avoid paying sales tax may result in a fine of $250 for each transaction for which the certificate is usedPrinted Name *Title *Date *Submit Signature Clear
