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Streamlined Sales and Use Tax Agreement

Certificate of Exemption Instructions

Use this form to claim exemption from sales tax on purchases of otherwise taxable items. The purchaser must complete all

fields on the exemption certificate and provide the fully completed certificate to the seller in order to claim exemption.

Warning to purchaser: You are responsible for ensuring that you are eligible for the exemption you are claiming. You will

be held liable for any tax and interest, and possibly penalties imposed by the member state due the tax on your purchase, if the

purchase is not legally exempt.

Purchaser instructions for completing the exemption certificate:

1. Some purchasers may wish to complete a single certificate for multiple states where they conduct

business and, regularly, make exempt purchases from the same seller. If you do, check the box on the

front of the SSUTA Certificate of Exemption to indicate that you are attaching the Multistate

Supplemental form.

CAUTION: Certificates completed with a multistate supplement may include non-member states of the

SST Governing Board, provided those states have agreed to accept the SSUTA Certificate of Exemption.

Both sellers and purchasers MUST BE AWARE that these additional non-member states may not have

adopted the SSUTA provisions for Multiple Points of Use and Direct Mail. Additionally, completion of

this certificate in its entirety may not fully relieve the seller from liability unless non-member states’

requirements have been met.

If you are not attaching the Multistate Supplemental form, enter the two-letter postal abbreviation for the

state under whose laws you are claiming exemption. For example, if you are claiming an exemption from

sales or use tax imposed by the state of Minnesota, enter “MN” in the boxes provided. If you are claiming

exemption for more than one member state, complete the SSUTA Certificate of Exemption: Multistate

Supplemental form.

2. Single purchase exemption certificate: Check this box if this exemption certificate is being used for

a single purchase. Include the invoice or purchase order number for the transaction.

If this box is not checked, this certificate will be treated as a blanket certificate. A blanket certificate

continues in force so long as the purchaser is making recurring purchases (at least one purchase within a

period of twelve consecutive months) or until otherwise cancelled by the purchaser.

3. Purchaser information: Complete the purchaser and seller information section, as requested. An

identification number for you or your business must be included. Include your state tax identification

number and identify the state and/or country that issued the number to you. If you do not have a state tax

identification number, enter the Federal Employers Identification Number (FEIN) issued to your

business, or if no FEIN number is required, enter your personal driver’s license number and the state in

which it is issued. Foreign diplomats and consular personnel must enter the individual tax identification

number shown on the sales tax exemption card issued to you by the United States Department of State’s

Office of Foreign Missions.

Multistate Purchasers: The purchaser should enter its headquarters address as its business address.

F0008 7/23/07

Sstgb Form F0003 - Streamlined Sales And Use Tax Agreement - Certificate Of Exemption Page 4