Form 1746 - Missouri Sales Or Use Tax Exemption Application With Instrucftions - 2012 Page 3
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4MISSOURI DEPARTMENT OF REVENUE
TAXATION DIVISION
FORM
P.O. BOX 358
JEFFERSON CITY, MISSOURI 65105-0358
1746
(573) 751-2836 FAX: (573) 751-9409
E-mail: salestaxexemptions@dor.mo.gov
(REV. 09-2012)
MISSOURI SALES OR USE TAX EXEMPTION APPLICATION
TYPE OF EXEMPTION
1. QUALIFYING FOR EXEMPTION AS: (CHECK ONE)
PUBLIC ELEMENTARY OR SECONDARY EDUCATION
CHARITABLE (Benefits the common good and welfare of the
community, not only within the organization, while relieving
PRIVATE NOT‑FOR‑PROFIT ELEMENTARY AND SECONDARY
government of a financial burden that it would otherwise be
EDUCATION (Must have received accreditation)
required to meet)
HIGHER EDUCATION (Must have received accreditation)
RELIGIOUS (Churches, ministries, and religious groups. Exemption
MISSOURI POLITICAL SUBDIVISION (Out-of-state political
applies to sales and purchases only if within the organization’s
religious, charitable, or educational functions)
subdivisions do not qualify)
FEDERAL OR MISSOURI STATE AGENCY
NOT-FOR-PROFIT CIVIC (Benefiting the citizenry at large on an
unrestricted basis. Exemption applies only if the sale or purchase is
MISSOURI COOPERATIVE MARKETING ASSOCIATION
made for the organization’s civic or charitable functions and activities)
(Exemption applies to purchases and only exempts state sales tax.
NOT-FOR-PROFIT SOCIAL, SERVICE, FRATERNAL
All purchases remain subject to local sales tax and all use taxes).
(Exemption applies only if the sale or purchase is made for the
By checking this box you are affirming that the association does at
organization’s civic or charitable functions and activities, and not
least 25% of its business with its members.
general operations of the organization)
NOTE: Unions, political organizations, and home owner associations do not qualify for a Missouri sales/use tax exemption.
CODE (DOR ONLY)
2
FEIN
. IF YOU HAVE EVER BEEN ISSUED A MISSOURI TAX I.D. NUMBER BY THE DEPARTMENT OF REVENUE, ENTER BELOW
INCORPORATED ORGANIZATIONS
MISSOURI CHARTER NUMBER
DATE INCORPORATED (MM/DD/YYYY)
_ _ / _ _ / _ _ _ _
MISSOURI CORPORATION
__ __ __ __ __ __ __ __ __ __
MISSOURI CERTIFICATE OF AUTHORITY NO.
DATE REGISTERED IN MISSOURI (MM/DD/YYYY)
STATE OF INCORPORATION
OUT-OF-STATE CORPORATION
_ _ / _ _ / _ _ _ _
ORGANIZATION NAME AND LOCATION
3. ORGANIZATION NAME
PHONE
STREET ADDRESS - DO NOT USE P.O. BOX OR RURAL ROUTE
(_ _ __ __) __ __ __ - __ __ __ __
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
WEB SITE ADDRESS
E‑MAIL ADDRESS
4. DOES YOUR ORGANIZATION OWN PROPERTY IN MISSOURI?
YES
NO
5. IS YOUR ORGANIZATION EXEMPT FROM PROPERTY TAX?
YES
NO
DATE ORGANIZATION ORIGINATED:
6. DOES YOUR ORGANIZATION MAKE RETAIL SALES?
YES
NO
IF YOU ANSWERED “YES”, DESCRIBE THE FREQUENCY AND TYPE OF SALES YOU MAKE.
MAILING ADDRESS
7. MAILING ADDRESS (IF DIFFERENT THAN ORGANIZATION ADDRESS)
STREET ADDRESS OR P.O. BOX
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
RECORD STORAGE
8. RECORD STORAGE ADDRESS (PLEASE DO NOT USE P.O. BOX OR RURAL ROUTE)
STREET ADDRESS — DO NOT USE P.O. BOX OR RURAL ROUTE
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
PLEASE COMPLETE AND SIGN BACK OF APPLICATION
DOR-1746 (09-2012)
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