Application For Sales And Use Tax Exemption For Nonprofit Organizations - Virginia Department Of Taxation Page 3

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Section V - Financial Information:
9.
Enter the total dollar amount of the organization’s annual gross revenue (AGR), fundraising expenses, and
administrative cost for the previous year. See page 3 for detailed instructions.
a) Enter the organization’s total annual gross revenue for the previous year. ___________________
b) Enter the organization’s total fundraising expenses incurred for the previous year. _____________
c) Enter the organization’s total administrative cost for the previous year. ______________________
Section VI - Total Purchases and Sales Made in Virginia:
10. Part I: Enter the total dollar amount of taxable purchases to be made in Virginia for the next year, the current
year, and the total taxable purchases made in the preceding year. Do not include the sales tax. Estimates are
acceptable. See page 3-4 of the instructions.
Annual Purchases Subject to Sales and Use Tax in Virginia
2009
2008
2007
Part II: Enter the total dollar amount of tangible personal property to be sold in Virginia for the next year, the
current year, and the total of tangible personal property sold in preceding year. Do not include the sales tax.
Estimates are acceptable. Failure to provide this information shall be the basis for the Department to refuse to
exempt your organization. See pages 3-4 of the instructions.
Annual Sales Subject to Sales and Use Tax
(Complete only if you are exempt from collecting the sales and use tax on items sold in Virginia).
2009
2008
2007
11. Are you required to file a federal Form 990 or 990 EZ with the IRS? See page 4 of the instructions.
□
□
YES
NO
If yes, you must attach a copy of the form. If no, please provide the names, addresses and telephone numbers
of only two members of the Board of Directors.
NAME
ADDRESS
______________________________________
_____________________________________
_____________________________________
______________________________________
_____________________________________
_____________________________________
12. Is the organization subject to Chapter 5 (§ 57-48 et seq.) of Title 57 of the Code of Virginia, relating to
charitable solicitation of contributions? See page 4 of the instructions.
□
□
YES
NO
If YES, you must provide proof of compliance. Proof of compliance shall be
documentation, which reflects registration with the Virginia Department of Agriculture and
Consumer Services (VDACS). For additional information, please contact VDACS at (804) 786-2042
.
or visit their web page at
Va. Dept. of Taxation
Rev. (01/04/08)
Page 3

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