Form 51a260 - Streamlined Sales And Use Tax Agreement - Certificate Of Exemption Page 2
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251A260 (2-10)
Page 2
Streamlined Sales and Use Tax Agreement
Certifi cate of Exemption:
Multi–state Supplemental
Name of purchaser
State
Reason for Exemption
Identifi cation Number (If Required)
AR
_________________________________________________
________________________________________
IA
_________________________________________________
________________________________________
IN
_________________________________________________
________________________________________
KS
_________________________________________________
________________________________________
KY
_________________________________________________
________________________________________
MI
_________________________________________________
________________________________________
MN
_________________________________________________
________________________________________
NC
_________________________________________________
________________________________________
ND
_________________________________________________
________________________________________
NE
_________________________________________________
________________________________________
NJ
_________________________________________________
________________________________________
NV
_________________________________________________
________________________________________
OH
_________________________________________________
________________________________________
OK
_________________________________________________
________________________________________
RI
_________________________________________________
________________________________________
SD
_________________________________________________
________________________________________
TN
_________________________________________________
________________________________________
UT
_________________________________________________
________________________________________
VT
_________________________________________________
________________________________________
WA
_________________________________________________
________________________________________
WI
_________________________________________________
________________________________________
WV
_________________________________________________
________________________________________
WY
_________________________________________________
________________________________________
SSUTA Direct Mail provisions are not in effect for Tennessee.
The following nonmember states will accept this certifi cate for exemption claims that are valid in their respective state. SSUTA
Direct Mail provisions do not apply in these states.
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
XX
_________________________________________________
________________________________________
SSTGB Form F0003 Exemption Certifi cate (8/27/09)
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