Form 1746 - Missouri Sales/use Tax Exemption Application

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MISSOURI DEPARTMENT OF REVENUE
TAXATION DIVISION
FORM
P.O. BOX 358
1746
JEFFERSON CITY, MISSOURI 65105-0358
MISSOURI SALES/USE TAX
(REV. 06-2009)
EXEMPTION APPLICATION
MAIL COMPLETED APPLICATION TO:
MISSOURI DEPARTMENT OF REVENUE
TAXATION DIVISION
P.O. BOX 358, JEFFERSON CITY, MISSOURI 65105-0358
(573) 751-2836
TDD 1-800-735-2966
FAX: (573) 751-9409
E-mail: salestaxexemptions@dor.mo.gov
CODE (DOR ONLY)
1. IF YOU HAVE EVER BEEN ISSUED A MISSOURI TAX I.D. NUMBER BY THE DEPARTMENT OF REVENUE, ENTER BELOW
FEIN
TYPE OF EXEMPTION
2. QUALIFYING FOR EXEMPTION AS: (CHECK ONE)
functions and activities, and not for general operations of the organization)
CHARITABLE (Benefits the common good and welfare of the community,
not only within the organization, while relieving government of a financial
PUBLIC ELEMENTARY OR SECONDARY EDUCATION
burden that it would be otherwise required to meet)
PRIVATE NOT-FOR-PROFIT ELEMENTARY AND SECONDARY
RELIGIOUS (Churches, ministries, and religious groups. Exemption
EDUCATION (Must have received accreditation)
applies to sales and purchases only if within the organization’s religious,
HIGHER EDUCATION (Must have received accreditation)
charitable, or educational functions)
NOT-FOR-PROFIT CIVIC (Benefiting the citizenry at large on an unre-
MISSOURI POLITICAL SUBDIVISION (Out-of-state political subdivisions do
stricted basis. Exemption applies only if the sale or purchase is made for
not qualify)
the organization’s civic or charitable functions and activities)
FEDERAL OR MISSOURI STATE AGENCY
NOT-FOR-PROFIT SOCIAL, SERVICE, FRATERNAL (Exemption applies
only if the sale or purchase is made for the organization’s civic or charitable
NOTE: Unions, political organizations, and home owner associations do not qualify for a Missouri sales/use tax exemption.
ORGANIZATION NAME AND LOCATION
3. ORGANIZATION NAME
STREET ADDRESS — DO NOT USE P.O. BOX OR RURAL ROUTE
PHONE
(__ __ __) __ __ __ - __ __ __ __
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
WEB SITE ADDRESS
E-MAIL ADDRESS
IS YOUR ORGANIZATION EXEMPT FROM PROPERTY TAX?
YES
NO
DATE ORGANIZATION ORIGINATED:
INCORPORATED ORGANIZATIONS
M
M
D
D
Y
Y
Y
Y
MISSOURI CHARTER NUMBER
DATE INCORPORATED
MISSOURI CORPORATION
__ __ __ __ __ __ __ __ __ __
MISSOURI CERTIFICATE OF AUTHORITY NO.
DATE REGISTERED IN MISSOURI
STATE OF INCORPORATION
M
M
D
D
Y
Y
Y
Y
OUT-OF-STATE CORPORATION
MAILING ADDRESS
4. MAILING ADDRESS (IF DIFFERENT THAN ORGANIZATION ADDRESS)
STREET ADDRESS OR P.O. BOX
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
RECORD STORAGE
5. RECORD STORAGE ADDRESS (PLEASE DO NOT USE P.O. BOX OR RURAL ROUTE)
STREET ADDRESS — DO NOT USE P.O. BOX OR RURAL ROUTE
CITY
STATE
ZIP CODE
COUNTY
__ __ __ __ __
PLEASE COMPLETE AND SIGN BACK OF APPLICATION
MO 860-2158 (06-2009)
DOR-1746 (06-2009)

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