Form St-R-30 - Application For Sale/use Tax Exemption Certificate For An Incorporated Nonprofit Organization Providing Certain Services For Hearing-Impaired Persons
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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 ORGANIZATION PROVIDING CERTAIN
SERVICES FOR HEARING-IMPAIRED PERSONS
Name of Corporation
_______________________________________________________
Name of Organization
_______________________________________________________
Physical Location
_______________________________________________________
Mailing Address
_______________________________________________________
_______________________________________________________
The statute reads, "Organizations providing certain services for hearing-impaired persons.
Sales to incorporated nonprofit organizations whose primary purposes are to promote public
understanding of hearing impairment and to assist hearing-impaired persons through the
dissemination of information about hearing impairment to the general public and referral to
and coordination of community resources available to hearing impaired persons. PL 1989, c.
533, §8 (new); c, 871, §14 (amd).
Is the organization incorporated? Yes ___ No ___
Send a copy of the articles of incorporation
Has the organization 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. Please forward any publications issued by your organization which would provide details regarding purpose,
mission and/or services offered, if applicable.
I hereby certify that ______________________________________________________ is an incorporated
nonprofit organization providing services for hearing-impaired persons. I therefore request that a sales/use tax
exemption certificate be issued to the above organization pursuant to Title 36 MRSA 1760 (70).
Date:
Signature: ___________________________________________
Tel:
Print Name: __________________________________________
Fed ID:
Title: ________________________________________________
Date Facility Opened: ___________________________________
ST-R-30
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E A R I N G
M P A I R E D
H O N E
E-mail:
sales.tax@state.me.us
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