E-585 - Nonprofit And Governmental Entity Claim For Refund State, County, And Transit Sales And Use Taxes

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4
E-585
Nonprofit and Governmental Entity Claim for Refund
State, County, and Transit Sales and Use Taxes
Web-Fill
PRINT
CLEAR
12-14
North Carolina Department of Revenue
Complete all of the information in this section.
Legal Name (First 32 Characters) (USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Account ID
Mailing Address
Federal Employer ID Number
City
State
Zip Code
County
Period Beginning (MM-DD-YY)
Name of Person We Should Contact if We Have Questions About This Claim
Contact Telephone
Period Ending (MM-DD-YY)
National Taxonomy of Exempt Entities Number
Fill in the circle that
Nonprofit entity as defined in G.S. 105-164.14(b) (Semiannually)
describes your
Governmental entity as defined in G.S. 105-164.14(c) (Annually)
(Nonprofit Entity Only)
organization.
1.
Name of Taxing County
(If more than one county, see instructions on Page 2 and attach Form E-536R.)
2.
Total Purchases of Tangible Personal Property and
State
Food, County & Transit
Services for Use on Which North Carolina State or
Food, County & Transit Sales or Use Tax Has Been
Paid Directly to Retailers (Do not include tax paid,
purchases for resale, or items described in box below.)
Tax paid on any of the following items are nonrefundable:
Electricity, piped natural gas, telecommunications and ancillary services, video programming, prepaid meal plans;
the purchase, lease, or rental of motor vehicles; local occupancy or local prepared food and beverage taxes; scrap tire
disposal or white goods disposal taxes; reimbursements for travel expenses; alcoholic beverages; digital property
3.
Amount of Sales and Use Tax Paid Directly
to Retailers on Purchases for Use
4.
Amount of Sales and Use Tax Paid Indirectly
on Building Materials and Supplies as Shown
on Contractors’ Statements
5.
Amount of Use Tax Paid Directly to the Department
of Revenue by the entity (Do not include tax collected
and remitted on sales made by the entity.)
6.
Total Tax (Add Lines 3, 4, and 5. Food, County & Transit
tax must be identified by rate on Line 8.) (For nonprofit
entity only; annual cap applies, see General Instructions.)
$
7.
Total Refund Requested
(Add State and Food, County & Transit tax on Line 6.)
8. Allocation of Food, County & Transit Tax on Line 6 (Enter the food, county & transit tax
paid at each applicable rate. If you paid more than one county’s tax, see the instructions on
Page 2 and attach Form E-536R.)
Transit 0.50% Tax
Food 2.00% Tax
County 2.00% Tax
County 2.25% Tax
Durham, Mecklenburg, Orange
Signature:
Date:
I certify that, to the best of my knowledge, this claim is accurate and complete.
Telephone:
Title:
For Departmental Use Only
Food Tax
County 2.00% Tax
County 2.25% Tax
Transit Tax
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State Tax
Total Tax
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Refund Approved:
As Filed
As Corrected
By:
Date:
MAIL TO: NC Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0001

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