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Form St-R-05 - Exemption Application Incorporated Nonprofit Home Construction Organization Constructing Low-Cost Housing

MAINE REVENUE SERVICES

SALES, FUEL & SPECIAL TAX DIVISION

EXEMPTION APPLICATION

INCORPORATED NONPROFIT HOME CONSTRUCTION ORGANIZATION

CONSTRUCTING LOW-COST HOUSING FOR LOW-INCOME PEOPLE

Name of Corporation _______________________________________________________

Name of Organization _______________________________________________________

Physical Location

_______________________________________________________

Mailing Address

_______________________________________________________

The statute reads, "Nonprofit home construction organizations. Sales to local branches of incorporated

nonprofit organizations whose purpose is to construct low-cost housing for low-income people. PL 1989,

c. 501, Pt. P, §30 (new); c. 533, §8 (new); c. 871, §13 (rpr)."

Is the organization incorporated? Yes ___ No ___

Has the organization 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

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 home construction organization. I therefore request that a sales/use tax exemption certificate be

issued to the above organization pursuant to Title 36 MRSA 1760 (67).

Date:

Signature: _____________________________

Tel:

Print Name: ____________________________

Fed ID: _______________________

Title: __________________________________

Date Facility Opened: _____________________

ST-R-05 (Rev 10/05)

Phone: (207) 624-9693

TDD: (888) 577-6690

Fax: (207) 287-6628

E-mail: salestax@maine.gov

Form St-R-05 - Exemption Application Incorporated Nonprofit Home Construction Organization Constructing Low-Cost Housing