Form St-R-07 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Private Residential Child Caring Institution
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1S T A T E O F M A I N E
M A I N E R E V E N U E S E R V I C E S
ADMINISTRATIVE & FINANCIAL
2 4
S T A T E H O U S E S T A T I O N
SERVICE
,
A U G U S T A
M A I N E
REBECCA M. WYKE
0 4 3 3 3 - 0 0 24
COMMISSIONER
John Elias Baldacci
JEROME D. GERARD
GOVERNOR
ACTONG EXECTUTIVE DIRECTOR
APPLICATION FOR SALE/USE TAX EXEMPTION CERTIFICATE
FOR AN INCORPORATED NONPROFIT PRIVATE RESIDENTIAL
CHILD CARING INSTITUTION
Name of Corporation
_______________________________________________________
Name of Child Caring Institution _______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
_______________________________________________________
The statute reads, "Other institutions. Sales to incorporated private nonprofit residential child caring
institutions, which are licensed by the Department of Behavioral and Developmental Services as child caring
institutions. PL 1975, c. 293, §4 (amd)."
Is the child caring institution incorporated? Yes ___ No ___
Send a copy of the articles of incorporation
Has the child caring institution received 501(c) nonprofit status from the IRS? Yes ___ No ___
Send a copy of the IRS determination letter indicating 501(c) nonprofit status
IN ORDER TO PROCESS THE APPLICATION THE FOLLOWING MUST BE INCLUDED
1.
Copy of the Articles of Incorporation, as well as a copy of the Constitution and/or By-law
2.
Copy of the IRS determination letter indicating 501(c) nonprofit status
3.
Copy of the license issued by the Department of Behavioral and Developmental Services.
I hereby certify that ______________________________________________________ is an incorporated
nonprofit child caring institution. I therefore request that a sales/use tax exemption certificate be issued
to the above organization pursuant to Title 36 MRSA 1760 (18-A).
Date:
Signature: ___________________________________________
Tel:
Print Name: _________________________________________
Fed ID:
Title: _______________________________________________
Date Facility Opened: _________________________________
ST-R-07
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E A R I N G
M P A I R E D
H O N E
E-mail:
sales.tax@state.me.us
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