Operator Certificate Of Compliance Form printable pdf download

2015 BELTRAMI COUNTY FAIR

ST19

MINNESOTA – REVENUE

Operator Certificate of Compliance

Person selling at event: Complete this certificate and mail it to the operator/organizer of the event. Operator/organizer of event-

Keep this certificate for your records.

Do not send this form to the Department of Revenue

Name of business or exhibiting at event____________________________________________________

Minnesota Tax ID Number____________________________

Seller’s complete address________________________________________________________________

Name of person or group organizing event__________________________________________________

Name and location of event______________________________________________________________

Date(s) of event_____________________________________

Describe the type of merchandise you plan to sell.

_________________________________________________________________________

Complete this section if you are not required to have a Minnesota ID Number.

____ I am selling only nontaxable items.

____ I am not making any sales at event.

____ I participate in a direct selling plan, selling for ________________(name of company), and the home

office or top distributor has a Minnesota Tax ID number and remits the sales tax on my behalf.

____ This is a nonprofit organization that meets the exemption requirements described below:

_____ Candy sold for fundraising purposes by a nonprofit organization that provides educational and

social activities for young people primarily aged 18 and under (MS 297A.70, subd. 13(a)(4).

_____ Youth or senior citizen group with fundraising receipts of $10,000 or less per year

(MS 297A.70 subd. 13(b)(1).

_____ A nonprofit organization that meets all the criteria set forth in MS 297A.70 subd. 14.

I declare that the information on this certificate is true and correct to the best of my knowledge and belief and

that I am authorized to sign this form.

Signature of seller _______________________________ Print name here____________________________

Date __________________________________________ Daytime phone____________________________

Penalty – Operators who do not have Form ST19 or a similar written document from sellers can be fined a

Penalty of $100 for each seller that is not in compliance for each day of the selling event.

PRINT FORM OUT AND MAIL TO:

Joe Waslaski

Space Rental Manager

8011 Birchmont Beach Road NE

Bemidji, MN 56601

218-751-3159 W

E-mail –

goldmine@paulbunyan.net

Operator Certificate Of Compliance Form