Form E-592a - Application For State Agency Exemption Number For Sales And Use Taxes
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1
2E-592A
4
Web-Fill
Application for State Agency Exemption Number
12-03
for Sales and Use Taxes
PRINT
CLEAR
North Carolina Department of Revenue
Office Use
1.
Federal Employer ID No.:
2.
N.C. Sales and Use Tax Account ID:
3.
State Agency/UNC Institution:
4.
Division:
5.
Location:
Street
(Not P.O. Box)
City
State
Zip Code
6.
Mailing Address:
Street or P.O. Box
City
State
Zip Code
7.
Description of Agency Operations:
Signature:
Date:
I certify that, to the best of my knowledge, this application is accurate and complete.
Name (Print):
Title:
E-mail:
Phone:
Mail to: N.C. Department of Revenue, Sales and Use Tax Division
P. O. Box 871, Raleigh, NC 27602-0871
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Parent category: Financial