Form St-R-32 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Home Health Care Agency
ADVERTISEMENT
1S T A T E O F M A I N E
M A I N E R E V E N U E S E R V I C E S
ADMINISTRATIVE & FINANCIAL
2 4
S T A T E H O U S E S T A T I O N
SERVICE
,
A U G U S T A
M A I N E
REBECCA M. WYKE
0 4 3 3 3 - 0 0 24
COMMISSIONER
John Elias Baldacci
JEROME D. GERARD
GOVERNOR
ACTONG EXECTUTIVE DIRECTOR
APPLICATION FOR SALE/USE TAX EXEMPTION CERTIFICATE
FOR AN INCORPORATED NONPROFIT HOME HEALTH CARE AGENCY
Name of Corporation
_______________________________________________________
Name of Home Health Care Agency ________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
_______________________________________________________
The statute reads, "Incorporated nonprofit home health care agencies certified under the United States Social
Security Act of 1965, Title XVIII, as amended."
Is the home health care agency incorporated? Yes ___ No ___
Send a copy of the articles of incorporation
Has the home health care agency received 501(c) nonprofit status from the IRS?
Yes ___ No ___
Send a copy of the IRS determination letter indicating 501(c) nonprofit status
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. Copies of any licenses in reference to this agency.
I hereby certify that ______________________________________________________ is an incorporated
nonprofit home health care agency. 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: __________________________________________
Tel:
Print Name: _________________________________________
Fed ID:
Title: ______________________________________________
Date Facility Opened: _________________________________
ST-R-32
P
RINTED ON RECYCLED PAPER
F
: ( 2 0 7 ) 2 8 7 - 6 6 2 8
A X
( 2 0 7 ) 2 8 7 - 4 4 7 7 ( H
I
)
P
: ( 2 0 7 ) 6 2 4 - 9 6 9 3
E A R I N G
M P A I R E D
H O N E
E-mail:
sales.tax@state.me.us
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form St-r-35 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Rural Community Health Center Engaged In, Or Providing Facilities For The Delivery Of Comprehensive Primary Health Care
Financial
Form St-r-18 - Application For Sale/use Tax Exemption Certificate Incorporated Nonprofit Memorial Foundations Or An Incorporated Nonprofit Historical Society Or An Incorporated Nonprofit Museum
Financial
Form St-r-05 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Home Construction Organization Constructing Low-cost Housing For Low-income People
Legal
Form St-r-39 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Area Agencies On Aging
Legal
Form St-r-33 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Community Action Agency
Legal
Form St-r-07 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Private Residential Child Caring Institution
Legal
Form St-r-35 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Rural Community Health Center Engaged
Legal
Related Categories
Parent category: Financial