Form St-R-19 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Fire Department
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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 FIRE DEPARTMENT
Name of Corporation
_______________________________________________________
Name of Fire Department _______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
_______________________________________________________
The statute reads, "Incorporated nonprofit fire departments."
Is the fire department incorporated? Yes ___ No ___
Send a copy of the articles of incorporation
Has the fire department 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
I hereby certify that ______________________________________________________ is an incorporated
nonprofit fire department. I therefore request that a sales/use tax exemption certificate be issued to the above
organization pursuant to Title 36 MRSA 1760 (26) and 08-125 CMR 302.
Date:
Signature: ___________________________________________
Tel:
Print Name: __________________________________________
Fed ID:
Title: _______________________________________________
Date Facility Opened: __________________________________
ST-R-19
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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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