Form Rv-093 - Sales Tax Exempt Status Application - 2003
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1
2Sales Tax Exempt
Status Application
FOR OFFICE USE ONLY
License Number: ____________________________________________________
File Code: E
Approved: ____ Denied: ____ Date: ________________ By: ______________
General Information Required From All Applicants.
1. Full name of organization: ______________________________________________________________________________________
2. Contact person : ______________________________________________________________________________________________
3. Mailing Address: Street or Box Number:____________________________________________________________________________
City:________________________ State:_______ Zip Code:______________ County_______________________________________
4. Federal ID Number:____________________________________________________________________________________________
5. Address of business, if different from No. 3: Street:____________________________________________________________________
City:__________________________________State:___________________Zip Code:____________County:_____________________
6. Business telephone:_________________________________________Contact’s home telephone:______________________________
! ! ! ! ! Governmental Agency
! ! ! ! ! Public or Municipal Corporation
7. Type of organization: (check one)
! ! ! ! ! Relief Agency
! ! ! ! ! Religious Educational Institution
! ! ! ! ! Private Educational Institution
8. Will there be more than one location of operation? ! ! ! ! ! Yes
! ! ! ! ! No
If yes, how many?___________________
9. Date the organization was formed:_________________________________________________________________________________
10. Date activities began in South Dakota:_____________________________________________________________________________
! ! ! ! ! Yes
! ! ! ! ! No
11. Does the organization currently have or ever had a tax license in South Dakota?
If yes, license number(s):________________________________________________________________________________________
Organizational Documents: (These documents will be kept on file with the Department of Revenue & Regulation)
! ! ! ! ! 1. Bylaws
! ! ! ! ! 2. Articles of Incorporation
! ! ! ! ! 3. Constitution, Articles of Association
! ! ! ! ! 4. If applying for relief agency exemption:
! ! ! ! ! Internal Revenue Section 501 (C) (3) exemption (Include a copy of IRS Form 1023, App. for Exemption)
! ! ! ! ! 5. If applying for either private or religious educational institution exemption:
! ! ! ! ! Internal Revenue Section 501 (C) (3) exemption or 501 (D) (Include a copy of the IRS Application for Exemption)
! ! ! ! ! Certification or Accreditation Approvals
! ! ! ! ! 6. If the organization does not have any of these documents, attach an explanation.
RV-093 07/03
Continue on Reverse Side
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Parent category: Financial