Form St-Er - Application For Sales Tax Exemption Renewal (For Non-Profit Organizations)

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Rev. 7/98
Form ST-ER
Massachusetts
Application for Sales Tax Exemption Renewal
Department of
(for Non-Profit Organizations)
Revenue
DOR use only:
Document location number
Date received
Registration Information
1.
2.
Federal Identification number
Certificate expiration date
DOR use only
3.
Name of organization
4.
Street address (PO box is not acceptable)
City/Town
State
Zip
Telephone number
Mailing Address
(if different from above)
5.
Street address (PO box is acceptable)
City/Town
State
Zip
Telephone number
General Information
6. Indicate type of organization:
Corporation
Trust or association
Fiduciary
Partnership
Other (specify):
7. Describe nature of business:
8. Check one:
Governmental
Charitable exempt purchaser
Federal Identification number
9. If a subsidiary corporation, enter name (below) and Federal ID number of parent corporation:
Signature
10. I hereby certify that the statements made herein have been examined by me and are, to the best of my knowledge and belief, true, correct, and
complete. Signed under the pains and penalties of perjury.
Signature of authorized individual
Date
Title
The signing of this application is evidence that you may be the person individually and personally responsible for any sums required to
be paid to the Commonwealth of Massachusetts General Laws, Chapter 64H, section 16 and Chapter 64I, section 17.
Note: When renewing your exempt purchaser status, be sure to include a copy of your IRS letter of exemption under Section 501(c)(3)
of the Internal Revenue Code. Subordinate organizations covered under an IRS group exemption letter should include a copy of the
group exemption ruling and a copy of the organization’s directory page listing the organization as an approved subordinate.
Mail this form and necessary attachments to: Massachusetts Department of Revenue
Bureau of Desk Audit
Exempt Organization Unit
200 Arlington St.
Chelsea, MA 02150

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