Application For Sales And Use Tax Exemption For Nonprofit Organizations
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3Virginia Department of Taxation
Application for Sales and Use Tax Exemption for Nonprofit Organizations
PLEASE PRINT OR TYPE
Reason For Submitting This Form
Please check the appropriate box that applies to your request.
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New Exemption Application
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Renewal Application
Federal Designation
If your organization is exempt from federal income tax under § 501(c)(3) or (c)(4) please check the appropriate box.
See instructions.
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501(c)(3)
501(c)(4)
Section I - Business Information
1.
Enter the Legal Name of the Organization: ___________________________________
2.
Enter the Federal Employer Identification Number (FEIN): _______________________
(Do not enter the dash)
3.
Enter the physical location of the organization.
Street ____________________________________________________________________
City _________________________________ State _______________ ZIP Code ____________
E-mail ______________________
4.
Enter the address if different from the physical address, where the financial records of the organization are
available for public inspection.
_______________________________________________________________________________
5.
Enter the name and mailing address of a contact person for the organization.
Name ___________________________________
Telephone Number ___________________
Title __________________________________________________________________________
Street _________________________________________________________________________
City ________________ State ________________ ZIP Code _________________
__________________
FAX Number ___________________
E-mail
6.
Check the box that best describes the primary function of the organization (choose only one).
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Educational
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Medical
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Civic and Community Service
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Cultural
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Church
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Other
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