Application For Certificate Of Exemption From Sales And Use Tax printable pdf download

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS

DEPARTMENT OF REVENUE

DIVISION OF TAXATION

FIELD AUDIT SECTION

ONE CAPITOL HILL

PROVIDENCE, RHODE ISLAND 02908

APPLICATION FOR CERTIFICATE OF EXEMPTION FOR AN EXEMPT ORGANIZATION

FROM THE RHODE ISLAND SALES AND USE TAX

NAME OF ORGANIZATION

NAME AND TELEPHONE NUMBER OF CONTACT PERSON

ADDRESS (NUMBER AND STREET)

CITY/TOWN, STATE AND ZIP CODE

MAILING ADDRESS (NUMBER AND STREET)

CITY/TOWN, STATE AND ZIP CODE

DATE ORGANIZED

DATE AND STATE INCORPORATED

FEDERAL IDENTIFICATION NUMBER

NOTE: A $25.00 NONREFUNDABLE APPLICATION FEE PAYABLE TO THE TAX ADMINISTRATOR MUST ACCOMPANY THIS APPLICATION.

Check the type of organization claiming exempt status - by law, no types other than those listed below are eligible

Hospital not operated for a profit

Educational institution empowered to confer diplomas, educational, literary or academic degree (RIGL 44-18-30(s))

Church - Attached questionnaire must accompany application

Orphanage

Other institution or organization operated exclusively for religious or charitable purposes

REQUIREMENT: INCLUDE A COPY OF YOUR IRS 501(c)(3) DETERMINATION LETTER

Interest-free loan associations not operated for profit

Nonprofit organized sporting leagues and associations and bands exclusively for boys and girls under the age of nineteen (19) years

Parent-teacher associations

State chapter of the following national vocational student organizations: DECA; FBLA/PBL; FFA; FHA/HERD; VICA

Organized nonprofit Golden Age and Senior Citizens Clubs exclusively for men and women 62 years of age or older and/or persons

who are under 62 years of age who are disabled and who reside in subsidized housing

If a branch or chapter, has the parent organization received an exemption from Federal Income Tax? YES

(If yes, attach a current letter from the parent organization certifying that the sub unit is a member.)

Check the appropriate box to indicate the type of organization:

Corporation (attach a copy of the articles of incorporation and bylaws)

Other (attach a copy of the articles of constitution and bylaws)

NOTE:

ALL ORGANIZATIONS MUST INCLUDE A COPY OF THE IRS LETTER INDICATING THEIR ASSIGNED FEDERAL IDENTIFICATION NUMBER.

ANY OUT-OF-STATE ORGANIZATION MUST INCLUDE A COPY OF THE EXEMPTION CERTIFICATE ISSUED BY ITS HOME STATE.

I HEREBY CERTIFY THAT THE INFORMATION ON THIS APPLICATION AND THE ATTACHMENTS THERETO IS CORRECT AND COMPLETE

TO THE BEST OF MY KNOWLEDGE AND BELIEF.

SIGNATURE OF OFFICER OR TRUSTEE

DATE

PRINT NAME AND TITLE OF OFFICER OR TRUSTEE

PLEASE NOTE THIS APPLICATION IS MADE WITH A WARRANTY THAT THE ORGANIZATION IS NEITHER A LODGE, SOCIAL, FRATERNAL,

TRADE OR PROFESSIONAL ASSOCIATION, NOR ANY OTHER TYPE OF NONPROFIT ORGANIZATION NOT LISTED ABOVE SINCE ONLY

THE ABOVE TYPES ARE ELIGIBLE FOR EXEMPTION.

Rev. 10/17/2007

Application For Certificate Of Exemption From Sales And Use Tax

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