Application For Sales And Use Tax Exemption For Nonprofit Organizations - Virginia Department Of Taxation
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3Virginia Department of Taxation
Application for Sales and Use Tax Exemption for Nonprofit Organizations
PLEASE PRINT OR TYPE
Please select the appropriate box that applies to your application request:
□
New exemption application
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Renewal exemption application
If your organization is exempt from federal income tax under § 501(c) of the Internal Revenue Code, select one of
the following below. See instructions for additional information.
□
□
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Gross Revenue less than $5,000 per year
501 (c)(3)
501(c)(4)
1.
Enter the Legal Organization Name: ___________________________________
2.
Enter the Federal Employer Identification Number (FEIN): _______________________
3.
Enter the Physical Address: (the actual physical location of the organization)
Street ____________________________________________________________________
City _________________________________ State _______________ ZIP ____________
Email ______________________
4.
List the address, if different from the physical address, where the organization’s financial records are available
for public inspection.
________________________________________________________________________________
5.
Enter the name and mailing address of a contact person:
Name ___________________________________
Phone ___________________
Title __________________________________________________________________________
Street _________________________________________________________________________
City ________________ State ________________ ZIP _________________
__________________
FAX Number ___________________
E-mail
6.
Check the classification below that best describes your organization’s purpose. (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
7.
If you are a church applying for a sales and use tax exemption, select only one of the following options: (See
page 2 of the instructions)
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Use Form ST-13A
□
Applying for a numbered certificate of exemption
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