Form Reg-1e - Application For St-5 Exempt Organization Certificate - For Nonprofit Exemption From Sales Tax - 2015
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1NEW JERSEY DIVISION OF TAXATION
OFFICIAL USE ONLY
REG-1E (04-15)
APPLICATION FOR ST-5 EXEMPT ORGANIZATION CERTIFICATE
MAIL TO:
DLN
- FOR NONPROFIT EXEMPTION FROM SALES TAX -
NJ Division of Taxation
Read Instructions Before Completing This Form
Regulatory Services Branch
Determination _________________
PO Box 269
Effective
Trenton, NJ 08695-0269
Date
___________________
Fax: (609) 989-0113
INSTRUCTIONS
The following items MUST be included with the application:
1.
IRS determination letter stating that the organization is exempt from income tax under 501(c)(3); or group exemption letter and letter or listing
from your central organization indicating that your subunit is included under a group 501(c)(3) exemption (an IRS 501(c)(3) determination letter is
not required for veterans organizations, volunteer emergency organizations, or PTA/PTO organizations);
2.
Certificate/Articles of Incorporation, Constitution, Charter or Trust Agreement; and/or
3.
ByLaws
Do not attach federal Form 1023, Application for Recognition of Exemption.
The Division may require the applicant to submit additional documents and information.
For further information please see:
Click in a shaded area to type your answers OR neatly print your answers.
-
A. Organization Name
B. FEIN
_____________________________________________
(Federal Identification Number, if any)
______________________________________________________________
E. Provide name and address that ensures delivery of ST-5 to
C. Registered Corporate Alternate Name (if any)
______________________
you.
______________________________________________________________
Name C/O ________________________________________________
D. Physical Location (An officer’s address may be used)
Entity Name _______________________________________________
Street_________________________________________________________
Street _____________________________________________________
City______________________ State _______ Zip Code ________________
City ______________________ State ______ Zip Code ____________
F. County / Municipality/ (or Out-of-State ) Code
(Find codes on next pages)
¨ Yes
¨ No
. Will you collect New Jersey Sales Tax?
If yes, give date of first sale ________ / ________ / ________
G
Month
Day
Year
(Collection not required if you have ST-5 exempt organization certificate and only occasional sales)
H. Will you soon begin paying wages or salaries to employees working in NJ or to NJ residents?
¨ Yes
¨ No
(If you already withhold NJ income tax, answer “No”.)
If yes, give date of first wage or salary payment _______/_______/_______ and give date that gross payroll will exceed $1,000 _______/_______/_______
I. IF A CORPORATION, give State of Incorporation ________, date ___/___/___ ATTACH a copy of the Certificate/Articles of Incorporation.
J. Contact Person ______________________Email Address _______________________________ Daytime Phone (____) _____________
K. Provide the following information for 2 responsible officers.
NAME (Last Name, First, MI)
TITLE
HOME ADDRESS (Street, City, State, Zip)
I certify that all information given in this application is correct and also that any documents submitted are true copies.
Your Signature______________________________________________________________________________________________
Name and Title (please print)_______________________________________________________________ Date____/____/_____
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