B01 Attachment J05 - 2022 Exemption Letter for a Qualifying Hospital.pdf

1600 West Monroe Street – PO Box 29099 Phoenix AZ 85038 www.azdor.gov

STATE OF ARIZONA

Department of Revenue

Douglas A. Ducey Governor

Rob Woods Director

January 6, 2022

Nicole Black Department of Health & Human Services Phoenix Area Indian Health Service

Email: Nicole.Black@ihs.gov

EXEMPTION LETTER FOR A QUALIFYING HOSPITAL

ORGANIZATION: DEPARTMENT OF HEALTH & HUMAN SERVICES

PHOENIX AREA INDIAN HEALTH SERVICE

EXEMPTION PERIOD: JANUARY 1, 2022 – DECEMBER 31, 2022

Based on a review of the information you provided, the Arizona Department of Revenue grants this Exemption Letter to Department of Health & Human Services Phoenix Area Indian Health Service. As a Qualifying Hospital, Department of Health & Human Services Phoenix Area Indian Health Service is entitled to an exemption from the Arizona Transaction Privilege Tax and the Use Tax for the period of January 1, 2022 through December 31, 2022 for only transactions occurring under the business classifications listed below. Please note that the transactions made in these business classifications are exempt to you as the customer. Also note that there are no deductions for transient lodging/hotel, and other exemptions are limited by statute. If you are conducting a taxable business activity, that activity remains taxable unless an applicable deduction or exclusion applies. Please review the Arizona Revised Statutes and/or the Model City Tax Code for more information.

Business Code Exempt Classification Statutory Reference 4 Utilities A.R.S. §42-5063(C)(3)(a) 8 Pipeline A.R.S. §42-5067(B)(1) 9 Publication A.R.S. §42-5065(B)(2)(a) 10 Job Printing A.R.S. §42-5066(B)(3)(a) 11 Restaurant A.R.S. §42-5074(B)(7) 14 Personal Property Rental A.R.S. §42-5071(B)(2)(a) 17 Retail A.R.S. §42-5061(A)(25)(a) 29 Use Tax A.R.S. 42-5159(A)(13)(a), (b), (c)

The organization is also entitled to an exemption from the Cities Privilege Tax and the Use Tax for the following business classifications only. Please note that the transactions made in these business classifications are exempt to you as the customer. Also note that there are no deductions for transient lodging/hotel, and other exemptions are limited by statute. If you are conducting a taxable business activity, that activity remains taxable unless an applicable deduction or exclusion applies.

Business Code Exempt Classification Statutory Reference 4 Utilities M.C.T.C.§ Sec. __-480(e) 9 Publication M.C.T.C.§ Sec. __-435(f) 10 Job Printing M.C.T.C.§ Sec. __-425(b)(5) 11 Restaurant M.C.T.C.§ Sec. __-455(c) 17 Retail M.C.T.C.§ Sec. __-465(p)

Use Tax Jet Fuel Tax Jet Fuel Use Tax (Local Option #LL) Utilities Services (add tax) Restaurants & Bars (add tax) Short Term Motor Vehicle Rental (PHX) Commercial Lease (Not Model Option #4 Cities) Rental/ Lease/ License of TPP Commercial Lease (add tax-see 213) Wastewater Utility Service

M.C.T.C.§ Sec. __-660(p) M.C.T.C.§ Sec. __-422(e) M.C.T.C.§ Sec. __-422(f) M.C.T.C.§ Sec. __-480(e) Local City Code M.C.T.C.§ Sec. 14-452 M.C.T.C § Sec. __-445(e) M.C.T.C.§ Sec. __-450(c)(5) M.C.T.C.§ Sec. __-446 M.C.T.C.§ Sec. __-485(b)

B01 Attachment J05 - 2022 Exemption Letter for a Qualifying Hospital

Nicole Black Department of Health & Human Services Phoenix Area Indian Health Service 1/6/2022

1600 West Monroe Street – PO Box 29099 Phoenix AZ 85038 www.azdor.gov

All locations claimed to be exempt by this organization are listed in Appendix “A” to this Exemption Letter.

This Exemption Letter is good only for the dates listed above. The Department may rescind this Exemption Letter if any of the information relied upon in granting this Letter is found to be inaccurate or if your organization ceases to qualify as an exempt entity under Arizona law. This letter may be disregarded if misused.

An Arizona Department of Revenue Transaction Privilege Tax Exemption Certificate (Arizona Form 5000HC) is used to document the applicability of exemptions from tax. Present a copy of this Exemption Letter to your vendors to substantiate your exempt status along with a properly completed Arizona Form 5000HC for the Appendix “A” location for which your organization is claiming an exemption.

Your organization must reapply to the Department annually, at least thirty (30) days before the expiration of this Exemption Letter, in order to avoid any lapse in your exempt status.

Information about the procedure and required documentation for obtaining an Exemption Letter can be found in Arizona Transaction Privilege Tax Procedure (TPP) 15-1 on the Department’s website. If you have any further questions, contact the Department at (602) 716-6372 or e-mail us at TPTHealthcare@azdor.gov.

Please submit all renewal requests by e-mail to: TPTHealthcare@azdor.gov

Sincerely, Larry Gulliford Arizona Department of Revenue Office of Economic Research & Analysis

Nicole Black

Phoenix Area Indian Health Service 1/6/2022

1600 West Monroe Street – PO Box 29099 Phoenix AZ 85038 www.azdor.gov

Appendix A

Phoenix Area Indian Health Service

Phoenix Indian Medical Center 4212 North 16th Street Phoenix, AZ 85016

Peach Springs Health Center P.O. Box 190 Peach Springs, AZ 86434

Whiteriver Service Unit P.O. Box 860 Whiteriver, AZ 85941

Desert Vision Youth Wellness Center P.O. Box 458 Sacaton, AZ 85247

Hopi Health Care Center P.O. Box 4000 Polacca, AZ 86042

Phoenix Area Office Two Renaissance Square 40 North Central Avenue Phoenix, AZ 85004

Colorado River Service Unit 12033 Agency Road Parker, AZ 85344

Havasupai Indian Health Station Supai, AZ 86435

Cibecue Health Center P.O. Box 37 Cibecue, AZ 85941

Desert Vision Youth Wellness Center 198 South Skill Center Sacaton, AZ 85147

Fort Yuma Service Unit P.O. Box 1368 Yuma, AZ 85366

Fort Yuma Service Unit 401 E. Picacho Road Winterhaven, CA 92283

Western Arizona District Office, OEHE 1553 W. Todd Drive, Ste. 107 Tempe, AZ 85283

Eastern AZ District Office, OEHE P.O. Box 756 Lakeside, AZ 85929

Eastern AZ District Office, OEHE 2450 E. Show Low Lake Road, Ste. 1 Show Low, AZ 85901