Form Str -11 - Incorporated Nonprofit Institution That Conduct Scientific And Technological Research

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MAINE REVENUE SERVICES
SALES, FUEL & SPECIAL TAX DIVISION
EXEMPTION APPLICATION
INCORPORATED NONPROFIT INSTITUTION THAT CONDUCT SCIENTIFIC
AND TECHNOLOGICAL RESEARCH FOR THE MAINE SCIENCE AND
TECHNOLOGY FOUNDATION AND RECEIVES FUNDING PURSUANT TO TITLE 5,
CHAPTER 385
Name of Corporation
_______________________________________________________
Name of Organization _______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
The statute reads, "Maine Science and Technology Foundation. Sales to institutions
incorporated as nonprofit organizations that conduct scientific and technological
research for the Maine Science and Technology foundation and receive funding pursuant
to Title 5, chapter 385."
Is the scientific and technological research foundation incorporated? Yes ___ No ___
Has the scientific and technological research foundation received 501(c) nonprofit status from
the IRS? Yes ___ No ___
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 agreement with the Science and Technology Foundation
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 hereby certify that ______________________________________________________ is an incorporated nonprofit scientific
and technological research foundation. I therefore request that a sales/use tax exemption certificate be issued to the above
organization pursuant to Title 36 MRSA 1760 (68)(84).
Date:
Signature: ________________________________________
Tel:
Print Name: _______________________________________
Fed ID# ______________________
Title: ______________________________________________
Date Facility Opened: _________________________________
STR – 11 (Rev 10/05)
Phone: (207) 624-9693
(207) 287-4477 (Hearing Impaired)
Fax: (207) 287-6628
E-mail: salestax@maine.gov

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