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

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

address.

4. Type of business: Circle the number that best describes your business or organization. If none of

the categories apply, circle number 20 and provide a brief description.

5. Reason for exemption: Circle the exemption that applies to you or your business and enter the

additional information requested for that exemption. If the member state that is due tax on your

purchase does not require the additional information requested for the exemption reason code

circled, enter “NA” for not applicable on the appropriate line. If an exemption that is not listed applies,

circle “M Other” and enter an explanation. The explanation for “M Other” must include a clear and

concise explanation of the reason for the exemption claimed. Some more common exemptions that

may be listed as explanation could be: interstate carrier for hire, qualified air pollution equipment,

enterprise zone, etc.

Multistate Purchasers: Attach the SSUTA Certificate of Exemption – Multistate Supplemental Form

and indicate the applicable reason for exemption and identification number (if required) for each of

the additional states in which the purchaser wishes to claim exemption from tax.

CAUTION: The exemptions listed are general exemptions most commonly allowed by member

states. However, each state’s laws governing exemptions are different. Not all of the reasons listed

may be valid exemptions in the state in which you are claiming exemption. In addition, each state has

other exemptions that may not be listed on this form. To determine what sales and use tax

exemptions are allowed in Wisconsin, please visit our website at:

F0008 7/23/07 -

Wisconsin revisions effective October 1, 2009

S-211-SST (R. 7/10)

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