Main Navigation
Form BOE-146-TSG Fillable Exemption Certificate ? Property Used in Tribal Self-Governance and Statement of Delivery
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)(date) (name and title) By mail common carrier (UPS FedEx etc ) or contract carrier (a shipping trucking or transport company) when both of the following I certify that the address below is the principal place where the tribal government meets to conduct tribal business In addition the retailer generally must deliver the product by: Takes ownership and delivery of an item at the tribal business location; and The contract of sale or other sales agreement cannot transfer ownership of the item to the tribal government before it is delivered to the tribal The property is delivered to the tribal government and ownership of the property transfers to the tribal government at the principal place where the The property is purchased by the tribal government for use in tribal self governance including the governance of tribal members the conduct of The property is used for purposes other than tribal self governance more than one half of the time in the first 12 months after the sale The tribal government or the tribal government s agent cannot take possession of the item before delivery at the tribal business location The tribal government s Indian tribe does not have a reservation; or the principal place where the tribal government meets to conduct tribal Using the retailer s vehicle or other facilities of the retailer; or (name of purchaser or purchaser s representative) (name of seller or seller s representative) (to be completed by California notary public or authorized tribal representative) (to be completed by purchaser) (to be completed by seller) ADDRESS (street city zip code) address of tribal business location); and also be obtained If the property is delivered by facilities of the retailer proper completion of the Statement of Delivery and Notary Statement may serve and identification number in addition to a description of the property AND STATEMENT OF DELIVERY and the property is for use in tribal self governance applicable) as documentation that transfer of ownership and delivery of the property to a tribal government occurred at the tribal business location If the property is blanket exemption certificate for multiple transactions will require proof of delivery of all property at the tribal business location BOE 146 TSG (FRONT) (9 12) STATE OF CALIFORNIA business is not on the tribe s reservation because the reservation does not have a building in which the tribal government can meet; or the business location; and by a duly authorized tribal official or his or her designee If you are delivering the property to the tribal government at the tribal business location by conduct tribal business cannot be on the tribe s reservation because the reservation does not have a building in which the tribal correct WITNESS my hand and official seal (if applicable) County of DATE OF DELIVERY DAYTIME TELEPHONE NUMBER delivered via common carrier or contract carrier completion of the Statement of Delivery and Notary Statement is not required Instead the retailer delivery of the property to the tribal government at the tribal business location The Notary Statement may be completed by a California notary public or DESCRIPTION OF PROPERTY PURCHASED DESCRIPTION OF PROPERTY SOLD document delivery at the principal place where the tribal government meets to conduct tribal business (tribal business location) when the tribal document that the property was sold to the tribal government of an officially recognized Indian tribe Completion of this section in full by a tribal does not have a reservation on which to conduct tribal government business or the principal place where the tribal government meets to DRIVER LICENSE NUMBER OR OTHER STATE ID EXEMPTION CERTIFICATE EXEMPTION CERTIFICATE PROPERTY USED IN TRIBAL SELF GOVERNANCE BOARD OF EQUALIZATION Fraudulent use of this statement to avoid the payment of California sales and use tax can result in severe penalties governance and/or to document that delivery occurred at the tribal business location The section labeled Exemption Certificate may be used to government can meet or the reservation lacks one or more essential utility services or mail service from the United States Postal Service; government is an officially recognized Indian tribe that does not have a reservation or the tribal business location cannot be on its Indian tribe s government will provide the retailer with sufficient documentation that the property was sold to the tribal government of an officially recognized Indian I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true and I have delivered the above described tangible personal property to the purchaser named above I hereby certify that the property described below is being purchased by the tribal government of an officially recognized Indian tribe that I hereby certify under penalty of perjury under the laws of the State of California that the below described tangible personal property was delivered to If use tax applies you must pay it directly to the Board of Equalization (BOE) If you are delivering the property to the tribal government at the tribal business location by your own facilities you may utilize this statement of delivery to indicating ownership transferred at the tribal business location You may verify the tribal business location on the BOE website at inter governmental relationships and the acquisition of trust land; and INVOICE NUMBER MODEL NAME (please print) NAME OF PURCHASER (please print) NAME OF SELLER NAME OF TRIBE NOTARY NOTARY STATEMENT NOTICE TO PURCHASER NOTICE TO SELLER NOTICE TO SELLER AND PURCHASER number in addition to a description of the property purchased If you intend to use this certificate as a blanket exemption certificate to cover multiple o The contract of sale or sales invoice must include a statement specifically requiring delivery at the tribal business location (for example F O B o The goods are in fact delivered to the tribal government at the tribal business location On before me personally appeared Please provide a complete description of the property purchased If the property is a vehicle please provide the year make model and identification PURCHASER S SIGNATURE recognized Indian tribe provided all of the following conditions are met: requirements are met: reservation because the reservation does not have a building in which the tribal government can meet or the reservation lacks one or more essential reservation lacks mail service from the United States Postal Service (USPS) or essential utility services; retailer s location Please note: This is a general description of transfers of ownership Specific rules may apply to certain types of sales and leases Retailers located outside Indian country may sell to Indian purchasers who request delivery at the tribal business location For a sale to qualify as a retain your bill of lading or other shipping documents as proof of delivery to the tribal business location along with your sales contract or sales invoice Sales tax does not apply when a retailer transfers ownership of merchandise (tangible personal property) to a tribal government of an officially SELLER S PERMIT NUMBER should retain a bill of lading or other documents showing delivery at the tribal business location along with a contract of sale or other sales agreement Signature specifically showing title passing to the tribal government at the tribal business location STATE State of California STATEMENT OF DELIVERY STREET ADDRESS the instrument the purchaser at the tribal business location on the date and at the place stated below If the property is a vehicle please provide the year make model their signature on the instrument the person(s) or the entity upon behalf of which the person(s) acted executed This document may be used to document that the sale was to the tribal government of an officially recognized Indian tribe for use in tribal self transactions please indicate this by including all tangible personal property in the description of the property purchased field below The use of a transfer of title (ownership) at the tribal business location both of the following conditions must be met: tribal government meets to conduct tribal business (tribal business location) tribe Additional documentation showing transfer of ownership and delivery of the property to the tribal government at the tribal business location must Use tax is due when the tribal government does both of the following: utility services or mail service from the United States Post Office It is recommended that you also complete the Notary Statement below to document utilizing a common carrier or a contract carrier you do not need to complete the Statement of Delivery or the Notary Statement Instead you should VIN/LIC NUMBER When accepted in good faith this exemption certificate may be used for the purchase of tangible personal property for use in tribal self governance When delivery does not take place as described above ownership of the item being sold or purchased generally transfers to the purchaser at the who proved to me on the basis of satisfactory evidence to the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacity and that by www boe ca gov/sutax/indianLandSales htm ZIP CODE