Arizona Contractor's Project Certificate (TPT)

Contractor's Project Certificate (TPT)
5009L Transaction Privilege Tax Contractor's Certificate
This certificate is not valid unless registered with the Department here.

Arizona Form

5009L

Arizona Department of Revenue

Contractor’s Project Certificate

This certificate shall serve as the exemption certificate prescribed under A.R.S. § 42-5009(L), and is only
to be used by subcontractors who do not hold a transaction privilege tax license.
A copy of the certificate, which has been registered with the Arizona Department of Revenue above, may only
be used with respect to an unlicensed contractor’s retail purchase of materials that will be incorporated into the
project referenced in Section C below, the gross receipts of which are subject to tax under A.R.S. § 42-5075.
The asterisked (*) items must be completed; otherwise the certificate is not valid.
A. Prime Contractor
*Name

*Transaction Privilege License Number

*Address

*AZ Registrar of Contractors’ License Number

*City	

State	

ZIP Code

*Telephone Number

*Project Start Date and Estimated Completion Date

*FAX Number

B. *Unlicensed Subcontractor Name (Attach list if necessary)

*Registrar of Contractors’ License #

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
ADOR 11233 (7/20)	

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Business Name (as shown in Section A)

Arizona Transaction Privilege Tax License Number

C. *Project Description
(For example; Building Permit Number, Address, Subdivision, Book/Map/Parcel Numbers, and/or Legal Description)

D. *Contract Pages Attached

 (check box)

In submitting this certificate to the Department for approval, the prime contractor must include at least the first page(s)
that indicate the parties to the contract, and the page(s) that describe the scope of work. The contract pages will be kept
on file by the Department.

If materials purchased under this certificate are subsequently used in the performance of a nontaxable contract,
the contractor that provided the certificate to a retail vendor and subsequently used the materials in a nontaxable
contract is liable in an amount equal to any retail transaction privilege tax, penalty and interest sourced to the
contractor’s principal place of business.
If any information that the Department of Revenue has relied upon was inaccurate or material information
was omitted when this certificate was used, the exemption certificate may be void. Any exemption claimed
using an unauthorized certificate shall be subject to recapture and the contractor shall make a payment to the
Department in an amount equal to the transaction privilege or use taxes that would have been due sourced to
the contractor’s principal place of business.
E. *Prime Contractor Certification
I, (print full name) 	

, hereby certify that I have provided an
accurate listing of the unlicensed subcontractors that will be working on this project. I certify that the information
on this Certificate is true, accurate and complete, and the contract pages that I have attached are for the project
described.
	

SIGNATURE OF PRIME CONTRACTOR		

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DATE		

	 	

TITLE

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Form 5009L – Contractor’s Project Certificate Instructions
PURPOSE
This certificate shall serve as the exemption certificate prescribed under A.R.S. § 42-5009(L), and is to be used
by subcontractors who do not hold a transaction privilege tax license. A copy of this project certificate registered
with the Arizona Department of Revenue must be provided to retail vendors in order to purchase materials
exempt from tax.

GENERAL INSTRUCTIONS
In order to ensure the effectiveness of the Certificate, all required fields must be completed.
Section A: Prime Contractor
The Name, Transaction Privilege License Number, Address, AZ Registrar of Contractors’ License Number,
Telephone Number, Project Start Date and Estimated Completion Date, and FAX Number fields of the Prime
Contractor section must be completed. The prime contractor is the entity responsible for the transaction privilege
tax on the project income.
Section B: Unlicensed Subcontractor Name
The Name and Registrar of Contractors’ License Number fields of the Subcontractor section must be complete.
If the subcontractor does not have an Arizona Registrar of Contractors’ license, please insert “N/A”.
Section C: Project Description
The project description must be sufficient to identify the location of the single project, or the request for the
Certificate will be deemed incomplete by the Department of Revenue.
Section D: Contract Pages
Submit copies of those pages from the actual signed contract that indicate the parties to the contract, and the
scope of the work of the contract. It is not necessary to submit the entire contract.
Section E: Prime Contractor Certification
The prime contractor submitting this certificate to the Department for registration must certify and sign the
certificate.
Incomplete certificate submissions will not be registered by the Department.
If any information which the Department of Revenue has relied upon was inaccurate or material information
was omitted when the certificate was used, the exemption certificate may be void. Any exemption claimed
using an unauthorized certificate shall be subject to recapture and the contractor shall make a payment to the
Department in an amount equal to the transaction privilege and use taxes that would have been due, along with
any applicable penalties and interest at the rate of the location of the retailer.
The completed certificate should be submitted to the following address for registration:
	
	
	
	
	

ATTN: Form 5009L Request
Arizona Department of Revenue
Collections Administrative Support
1600 W. Monroe Street – Division Code 23
Phoenix, AZ 85007-2650

	
	

or email to:
[email protected]

ADOR 11233 (7/20)