1. Utah State Tax Commission
TC-721CNG
Exemption Certificate for Compressed Natural Gas
Rev. 12/08
(Sales, Use, Municipal Energy and Compressed Natural Gas)
Name of business claiming exemption (buyer) Telephone Number
Street Address City State ZIP Code
Authorized Signature Name (please print) Title
Date
Sales Tax Account Number:
Municipal Energy Sales
and Use Account Number:
CNG Account Number:
Name of Seller or Supplier:
If you have questions, contact Taxpayer Services (preferably in writing), Utah State Tax Commission, 210 N 1950 W, Salt Lake City, UT 84134.
Telephone 801-297-3525, or toll free 1-800-662-4335, ext. 3525.
DO NOT SEND THIS CERTIFICATE TO THE TAX COMMISSION
Keep it with your records in case of an audit.
This certificate is not valid unless it is filled in completely.
A sales tax license number, a municipal energy sales and use account number, and a CNG license are required.
Compressed Natural Gas (CNG)
Buyer Certifies: I will compress a portion of my natural gas purchases for use in motor vehicles, which will therefore be subject
to the fuels tax. I will report CNG used in motor vehicles on the highway on my Utah CNG tax return. The remainder will be subject
to use tax and to municipal energy sales and use tax, which I will report on my Sales and Use Tax Return and on my Municipal
Energy Sales and Use Tax Return.
IMPORTANT: To protect your privacy, use the quot;Clear formquot; button when you are finished. Clear form
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Note to seller: Keep this certificate on file since it must be available for audit review.
Note to buyer: Keep a copy of this certificate for your records. You must notify the seller of cancellation,
modification, or limitation of this exemption.
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If you need an accommodation under the Americans with Disabilities Act, contact the Tax Commission at 801-297-3811 or TDD 801-297-2020.
Please allow three working days for a response.