Virginia Department of Taxation
Form NP-1
Sales and Use Tax Exemption Application for
Nonprofit Organizations
Please read instructions carefully before completing this form. For assistance call (804) 371-4023
:
Completed form can be mailed or faxed to
Virginia Department of Taxation
Nonprofit Exemption Unit
Post Office Box 27125
Richmond, VA 23261-7125
FAX Number: (804) 786-2645
Section I- Part 1: Reason for Submitting Form
Please check the appropriate box that applies to your request. See page 1of the instructions.
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New Exemption Application
Renewal Application
Part 2
Internal Revenue Service - Exempt Designation
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If the organization is exempt from federal income tax under sections 501(c)(3) or (c)(4), please check the
appropriate box. See page 1 part 2 of the instructions.
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501(c)(3)
501(c)(4)
Section II - Business Information
1.
Enter Legal Name of the Organization: ___________________________________
2.
Enter organization’s Federal Employer Identification Number (FEIN): _______________________
3.
Enter physical address of the organization. See page 1 of the instructions.
Street ____________________________________________________________________
City _________________________________ State _______________ Zip Code ____________
4.
Enter address if different from the physical address, where the financial records of the organization are
available for public inspection (certificate will be mailed to the physical address provided). See page 1 of the
instructions.
_______________________________________________________________________________
_______________________________________________________________________________
5. Enter name and mailing address of a contact person for the organization. See page 1 of the instructions.
Name ___________________________________
Telephone Number ___________________
Title __________________________________________________________________________
Street _________________________________________________________________________
City ________________ State ________________ Zip Code _________________
__________________
FAX Number ___________________
E-mail address
6.
Check the box that best describes the primary purpose of the organization (choose only one). See page 2 of the
instructions.
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Civic and Community Service
Educational
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Church
Medical
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Cultural
Va. Dept. of Taxation
Rev. (1/21/2015)
Page
1
6210202