Transaction Privilege Tax Healthcare Exemption Certificate

The purpose of the Certificate is to document tax-exempt transactions with qualified purchasers. It is to be filled out completely by the purchaser and furnished to the vendor. The vendor shall retain this Certificate along with a copy of the organization’s annual “Exemption Letter” for single transactions or for specified periods as indicated.

The form does need to be sent to the Arizona Department of Revenue. 

Form Number
Form Year Form Publish Date
Current Download 12/04/2020