Declaration of domicile for purchase of residential utilities

We ask that you complete the entire form. All fields marked with an asterisk (*) are required.

Landlords or other accountholders of multi-unit dwellings served by a single meter (master meter) use the multi-unit declaration of domicile.

In accordance with the provisions of KRS 139.470(7) this declaration may be executed for the purchase of electricity and natural gas by Kentucky residents for use in heating, water heating, cooking, lighting, and other residential uses.

The below accountholder or representative declares that the utility service address listed below is the place of domicile* of a Kentucky resident and the purchase of residential utilities for use at this address meets the qualifications for exemption from Kentucky sales and use tax under KRS 139.470(7).

The exemption will begin on the date of the first full billing cycle after the date of receipt of this declaration by Louisville Gas and Electric Company / Kentucky Utilities Company.

* Place of domicile means “the place where an individual has his or her legal, true, fixed and permanent home and principal establishment, and to which, whenever the individual is absent, the individual has the intention of returning.”
If we need to contact you for additional information, please provide your phone number and email address.

Under penalties of perjury, I swear or affirm that the information on this declaration is true and correct as to every material matter.