Exemption form for certain agricultural purposes.

In connection with the purchases of tangible personal property described in subdivisions (2), (4), and (22) of subsection (a) of Section 40-23-4, and therefore exempt from taxation as therein provided, the filing by the purchaser at retail of such property with the seller of a certificate in substantially the following form shall relieve the seller of any obligation to collect tax under Chapter 23 of this title with respect to the sales described therein:

Exemption Certification Respecting Fertilizers, Insecticides, Fungicides, and Seedlings

The undersigned __________________________________

(name) (address)

_______________________, hereby certifies that the items of (SCS Farm number, if available) tangible personal property purchased by the undersigned on this date from ____________________ (itemized receipt attached) will be used (name of retailer)

for the purposes described in subdivisions (2), (4), or (22) of subsection (a) of Section 40-23-4, in such manner as will render the aforesaid purchase(s) exempt from sales or use taxation under the laws of Alabama. The undersigned is aware that liability to pay any such tax ultimately determined to be applicable with respect to the items so purchased will be the exclusive responsibility of the undersigned.

______________________ ___________________ (Signature) (Date)

The seller shall furnish a copy of said certificate, with receipt attached, to the purchaser and must retain the original thereof for examination by the Department of Revenue for a period of not less than one year from the date thereof.

(Acts 1992, No. 92-343, p. 720, §4.)