Form St-R-22 - For Sales/use Tax Exemption Certificate

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MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
APPLICATION FORM
FOR SALES/USE TAX EXEMPTION CERTIFICATE
FOR AN INCORPORATED NON-PROFIT EDUCATIONAL INSTITUTION
Name of Corporation
_______________________________________________________
Name of School
_______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
14-E. School.
The statute reads,
"School" means a public or incorporated nonprofit elementary, secondary
or postsecondary educational institution that has a regular faculty, curriculum and organized body of pupils or students in
attendance throughout the usual school year and that keeps and furnishes to students and others records required and accepted for
entrance to schools of secondary, collegiate or graduate rank.
PLEASE ANSWER THE FOLLOWING QUESTIONS
1. Is the school incorporated?
YES ___ NO ___
You must send a copy of the articles of incorporation
2. Has the school received 501(c)3 nonprofit status from the IRS?
YES ___ NO ___
You must send a copy of the IRS determination letter.
3. Does the school have a regular faculty and curriculum?
YES___ NO___
4. Does the school have a student body attending through the normal school year?
YES___ NO___
5. Does the school keep academic records of students attendance and completion?
YES___ NO___
6. Do the students receive credits transferable for acceptance to High School, or College?
YES___ NO___
Note: All information contained on this application is subject to VERIFICATION by Maine Revenue Services.
Maine Revenue Services may request additional information or documentation necessary to determine eligibility.
“I certify under the pains and penalty of perjury that ________________________________________________ is
an incorporated non-stock educational institution.” I therefore request that a sales/use tax exemption certificate be
issued to the above organization pursuant to Title 36 MRSA 1760 (16).
Date:
Signature of School Official: _________________________________
Tel:
Print Name: _______________________________________________
Fed ID:
Title: _______________________________________________
Date Facility Opened: __________________________________
ST-R-22 (Rev 6/08)
Phone: (207) 624-9693
TDD: (888) 577-6690
Fax: (207) 287-6628
E-mail: salestax@maine.gov

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