Form Npo - Retail Sales And Use Tax Exemption Application Page 4

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12. Has your organization registered with the Virginia Department Agriculture and Consumer Services (VDACS),
Office of Charitable and Regulatory Services to solicit contributions in Virginia? See pages 3-4 of the
instructions.
□
□
YES
NO
NOTE: Before TAX can approve your exemption application, you must contact VDACS to verify if your
organization has met the registration requirements. If VDACS determines that your organization is not required
to register, check NO. If your organization is required to register, check YES and provide proof of registration
from VDACS. Contact VDACS at (804) 786-1343.
Section VII - Signature
I declare that this organization’s financial information is true, accurate, and complete.
___________________________________________________________ Date __________________
Authorized Representative
MAILING INFORMATION: Send completed form with attachments or change of address to:
Virginia Department of Taxation
Office of Customer Services
Nonprofit Exemption Unit
Post Office Box 27125
Richmond, Virginia 23261-7125
Telephone Number (804) 371-4023
Fax: 804-786-2645
CHECKLIST
Please make sure all questions are answered and that the following documents are included with
the application, if required:
501(c)(3) or 501(c)(4) - IRS Determination Letter
Mission Statement or Statement of Purpose
Proof of registration for Virginia Solicitation of Contributions Law
Federal Form 990, 990-EZ, 990-PF, 990-N, or substitute form
Independent Financial Audit or Review from an Independent Certified Public Accountant
Estimate of Total Taxable Purchases in Virginia (estimates are acceptable)
Authorized Representative’s Signature
NOTE: Incomplete applications will not be processed
Va. Dept. of Taxation
Rev. (08/15/2013)
Page 4

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