Form E-595a - Application For Direct Pay Permit For Sales And Use Taxes On Tangible Personal Property
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1
2Application for Direct Pay Permit
E-595A
for Sales and Use Taxes
on Tangible Personal Property
3-02
Office Use
North Carolina Department of Revenue
1.
Federal Employer ID No.:
(If request is for more than one account ID with the same FEIN,
attach a sheet and list the account IDs, trade names, and
2.
N.C. Sales and Use Tax Account ID:
business locations in N.C.)
3.
Legal Business Name:
4.
Trade Name (DBA Name):
5.
Business Location in N.C.:
Street
(Not P.O. Box Number)
City
State
Zip Code
County
6.
Mailing Address:
Street or P.O. Box
City
State
Zip Code
7.
Number of locations in N.C.:
8. Number of locations outside N.C.:
9.
Type of Business:
10.
Dollar amount of annual purchases:
11.
Principal reason for requesting a direct pay permit:
The place of business where the property will be used is not known at the time of purchase.
Provide one example:
The manner in which the property will be used is not known at the time of purchase.
Provide one example:
Signature:
Date:
I certify that, to the best of my knowledge, this application is accurate and complete.
Name (Print):
Title:
E-mail:
Phone:
Mail to: N.C. Department of Revenue, Sales and Use Tax Division
P. O. Box 871, Raleigh, NC 27602-0871
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