Form Rv-093 - Sales Tax Exempt Status Application & Instructions (Page 3 of 4) in pdf

Sales Tax Exempt

Status Application

Sales Tax Exempt Status Application

Full name of organization:__________________________________________________________________________________

Contact person: _____________________________________ Social Security Number ________________________________

Title: ______________________________________________ Email Address:________________________________________

Website Address: ______________________________________ South Dakota Physical Location:________________________

Mailing Address: Street or Box Number:_______________________________________________________________________

City:________________________ State:_______ Zip Code:______________ County_______________________________

Federal ID Number:_______________________________________________________________________________________

Address of business, if different than above: Street: _____________________________________________________________

City:__________________________________State:___________________Zip Code:____________County:_____________

Business telephone:__________________________________ Contact’s home telephone:_______________________________

Governmental Agency /Public or Municipal Corporation

Type of organization: (check one)

Public School District

Relief Agency

Religious Educational Institution

Private Educational Institution

Will there be more than one location of operation?

Yes

If yes, how many?___________________

Date the organization was formed: _____________

Date activities began in South Dakota: ___________

Does the organization currently have or ever had a tax license in South Dakota?

Yes

If yes, license number(s):_______________________________________________________________________________

Please Email, Fax, or Mail Organizational Documents: (These documents will be kept on file with the Department

of Revenue & Regulation)

1. Bylaws

2. Articles of Incorporation

3. Constitution, Articles of Association

4. If applying for relief agency exemption:

Internal Revenue Section 501 (C) (3) exemption (Include a copy of IRS Form 1023, App. for Exemption)

Budget or Financial Statement

5. If applying for either private or religious educational institution exemption:

Internal Revenue Section 501 (C) (3) exemption or 501 (D) (Include a copy of the IRS Application for Exemption)

Certification or Accreditation Approvals

6. If the organization does not have any of these documents, attach an explanation.

RV-093 05/11

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Form Rv-093 - Sales Tax Exempt Status Application & Instructions Page 3