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Massachusetts exempt certificate 2026

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Form ST-12B is a Sales Tax Exempt Certificate issued by the Massachusetts Department of Revenue for certain medical equipment prescribed by physicians. It outlines the process for physicians to certify the medical necessity of specific items, such as kidney dialysis machines and oxygen concentrators, which are exempt from sales and use tax. The form requires completion by both the physician and the purchaser, and emphasizes the importance of proper documentation to substantiate tax-exempt sales.

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Click ‘Get Form’ to open the Massachusetts Exempt Certificate in the editor.
In Part A, enter the patient's name and provide a full description of the medical equipment prescribed. Ensure that you select items from the list provided, such as kidney dialysis machines or oxygen concentrators.
The physician must sign and include their registration number and address in Part A. This certifies that the equipment is medically necessary.
Move to Part B, where the purchaser needs to fill in their name and address. The purchaser must also sign under penalties of perjury.
Ensure all sections are completed accurately before saving your document. Vendors should retain a copy for tax records.

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2010	4.9 Satisfied (27 Votes)

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