Form Str-45 - Application For Sale/use Tax Exemption Certificate For A Nonprofit Organization For Eye Banks
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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 A NONPROFIT
ORGANIZATION FOR EYE BANKS
Name of Corporation
_______________________________________________________
Name of Organization
_______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
_______________________________________________________
The statute reads, "Eye Banks” Sales to nonprofit organizations whose primary purpose is to obtain, medically
evaluate and distribute eyes for use in corneal transplantation, research and education. [1993, C. 532, §1 (new).]
Has the organization 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 organization’s official constitution, by-laws or statement of purpose.
2. Copy of the IRS determination letter indicating 501(c) nonprofit status.
3. Please forward any publications issued by your organization which would provide details regarding purpose,
mission and/or services offered, if applicable.
I hereby certify that ______________________________________________________ is an organization
whose primary purpose is to obtain, medically evaluate and distribute eyes for use in corneal transplantation,
research and education. I therefore request that a sales/use tax exemption certificate be issued to the above
organization pursuant to Title 36 MRSA 1760 (77).
Date:
Signature: ________________________________________
Tel:
Print Name: _______________________________________
Fed ID:
Title: ____________________________________________
Date Facility Opened: _______________________________
STR-45
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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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