Form St-R-09 - Exemption Application For A Regularly Organized Church

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MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
EXEMPTION APPLICATION
FOR A REGULARLY ORGANIZED CHURCH
Name of Corporation
______________________________________________________
Name of Church
______________________________________________________
Physical Location
______________________________________________________
Mailing Address
______________________________________________________
______________________________________________________
The statute reads, "Sales to regularly organized churches or houses of religious worship"
Please check the appropriate answers.
1
. Does the church have a constitution or corporate charter binding on its members, and rules or by-laws for the governing of it’s
affairs?
YES_____ Please enclose a copy.
NO____
2. Does the church have regular services open to the public?
YES_____HOW OFTEN____
NO____
3. Does the church have a regular congregation, the majority of which its members are not from one family within the third
degree if kinship?
YES_____HOW MANY_____
NO____
4. Does the church have its primary place of religious worship in a building that is not the residence of any of its organizers,
leaders, or members of the congregation?
YES_____
NO____
5. Does the church have a “dissolution clause” in the articles of incorporation that states that no members shall be entitled to
share in the distribution of any of the assets in the event of the corporation dissolving?
YES_____ Please enclose a copy
NO____
If you answered “NO” to any of the above questions, Stop, You do not qualify.
.
Note: All information contained on this application is subject to VERIFICATION by Maine Revenue Services
Maine Revenue Services may request additional information or documentation necessary to determine eligibility.
I hereby certify under the pains and penalties of perjury that _______________________________________is a nonprofit
regularly organized church or house of religious worship.” I therefore request that a sales/use tax exemption certificate be issued
to the above organization pursuant to Title 36 MRSA 1760 (16).
Date:__________________________ Signature of Church Official:____________________________
Tel: ___________________________ Print Name: _________________________________________
Fed ID:________________________ Title: _______________________________________________
Date Facility Opened:__________________________________
ST-R-09 (Rev. 10/2005)
Phone: (207) 624-9693
TDD: (888) 577-6690
Fax: (207) 287-6628
E-mail: salestax@maine.gov

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