Form G-6s - Application For Exemption From General Excise Taxes (Short Form)
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FORM G-6S
STATE OF HAWAII — DEPARTMENT OF TAXATION
(REV. 2009)
APPLICATION FOR
EXEMPTION FROM GENERAL EXCISE TAXES
(SHORT FORM)
PLEASE READ THE INSTRUCTIONS (FORM G-6A) BEFORE COMPLETING THIS APPLICATION
1.
NAME OF ORGANIZATION:
(Type or print clearly the full name of your group or organization)
Mailing Address:
Business Address:
E-mail:
Website (if any):
Contact Person:
Daytime Telephone No.: (
)
2.
The above-named organization is applying for exemption from general excise taxes under the following
general excise tax section: (Check only one box. See instructions for more information.)
Section 237-23(a)(3), Hawaii Revised Statutes
Section 237-23(a)(5), Hawaii Revised Statutes
Section 237-23(a)(4), Hawaii Revised Statutes
Section 237-23(a)(6), Hawaii Revised Statutes
3.
Effective date requested
. See instructions for required statement.
4.
Date Organization’s Hawaii Activity Began if Different from Date of Inception:
5.
The following items MUST be submitted with this completed application: (See instructions for more information.)
A. Copy of filed federal Form 1023 with all attachments
Mail the completed application to:
Hawaii Department of Taxation
(for organizations described in IRC section 501(c)(3)
Technical Section
or
P. O. Box 259
Copy of filed federal Form 1024 with all attachments
Honolulu, HI 96809-0259
(for organizations described in IRC sections 501(c)(4),
(6), or (8)
B. Copy of IRS determination letter granting federal tax exemption. If you requested an IRS determination but
have not received it, check this box ..........................................................................................................
Upon receipt of the IRS determination letter, a copy must be submitted to the Department of Taxation.
C.
Twenty Dollars ($20) Registration Fee enclosed, OR (check only one)
The $20 general excise license fee has been paid. Enter your general excise Hawaii Tax I.D. Number
here: W __ __ __ __ __ __ __ __ - __ __.
D.
Form BB-1. (Submit this form only if the organization is/will be fundraising and does not have a GET
license.
DECLARATION
I hereby declare under penalties provided by section 231-36, HRS, that I have examined this application and accompanying
attachments, and, to the best of my knowledge and belief, they are true, correct, and complete.
Signature of Officer or Duly Authorized Agent
Title
Date
FOR OFFICIAL USE ONLY:
Approved by:
Date Approved:
Title:
FORM G-6S
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