SD EForm - 0856
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South Dakota Department of Revenue
Motor Fuel Tax
445 East Capitol Avenue
Pierre, SD 57501-3100
APPLICATION FOR MOTOR FUEL TAX EXEMPTION
MOTOR FUEL PURCHASES BY SOUTH DAKOTA INDIAN TRIBES
PART I. IDENTIFICATION
Full name of organization_________________________________________________________________
Address (number & street)_________________________________________________________________
City or town____________________________________________________________________________
Date activities commenced in South Dakota___________________________________________________
Date organization was formed______________________________________________________________
Was this organization founded by the tribe?___________________________________________________
Is this organization incorporated pursuant to the laws of South Dakota?_____________________________
Is the Board of Directors or Trustees composed exclusively of members of a recognized Indian Tribe?
Is the operation of the school being governed by extensive federal regulations or supervised by the Bureau
of Indian Affairs?_______________________
If yes, please specify the regulations and agency_______________________________________________
Are there classes designed for Indian students which are not available in the public school system?
____________________ If yes, please list classes______________________________________________
PART II. ORGANIZATIONAL DOCUMENTS (These documents will not be returned)
Attach copies of the following:
1. Bylaws or other code of regulations;
2. Articles of Incorporation;
3. Internal Revenue Section 501 (C ) (3) or 501 (D) exemption (include with exemption a copy of the IRS
application for exemption);
4. Constitution, Articles of Association;
5. Certification or accreditation approvals.